Metagenomic next-generation sequencing for pulmonary infections diagnosis in patients with diabetes

• Published in: BMC pulmonary medicine Vol. 23; no. 1; p. 142
• Main Authors: Zhang, Siqin, Ou, Jing, Tan, Yuxue, Yang, Bin, Wu, Yaoyao, Liu, Lin
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 28.04.2023; BioMed Central; BMC
• Subjects: Analysis; Antibiotics; Bacteria; Bronchoalveolar Lavage Fluid; Bronchoscopy; Bronchus; Cardiovascular disease; Care and treatment; China; Clinical outcomes; Computational biology; Diabetes; Diabetes Mellitus; Diabetics; Diagnosis; DNA sequencing; Forecasts and trends; Fungi; Genomes; High-Throughput Nucleotide Sequencing; Hospitals; Humans; Hypertension; Infections; Klebsiella pneumoniae - genetics; Lavage; Lung diseases; Metagenomic next-generation sequencing; Metagenomics; Microorganisms; Mortality; Next-generation sequencing; Nucleotide sequencing; Parasites; Pathogens; Pneumonia; Prevention; Pulmonary infection; Pulmonology; Retrospective Studies; Risk factors; Sensitivity and Specificity; Stroke; Tuberculosis; Ventilators; China; Metagenomic next-generation sequencing; Diabetes; Diagnosis; Pulmonary infection
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-023-02441-4

Diabetes mellitus is a major cause of high mortality and poor prognosis in patients with pulmonary infections. However, limited data on the application of metagenomic next-generation sequencing (mNGS) are available for diabetic patients. This study aimed to evaluate the diagnostic performance of mNGS in diabetic patients with pulmonary infections. We retrospectively reviewed 184 hospitalized patients with pulmonary infections at Guizhou Provincial People's Hospital between January 2020 to October 2021. All patients were subjected to both mNGS analysis of bronchoalveolar lavage fluid (BALF) and conventional testing. Positive rate by mNGS and the consistency between mNGS and conventional testing results were evaluated for diabetic and non-diabetic patients. A total of 184 patients with pulmonary infections were enrolled, including 43 diabetic patients and 141 non-diabetic patients. For diabetic patients, the microbial positive rate by mNGS was significantly higher than that detected by conventional testing methods, primarily driven by bacterial detection (microbes: 95.3% vs. 67.4%, P = 0.001; bacteria: 72.1% vs. 37.2%, P = 0.001). mNGS and traditional tests had similar positive rates with regard to fungal and viral detection in diabetic patients. Klebsiella pneumoniae was the most common pathogen identified by mNGS in patients with diabetes. Moreover, mNGS identified pathogens in 92.9% (13/14) of diabetic patients who were reported negative by conventional testing. No significant difference was found in the consistency of the two tests between diabetic and non-diabetic groups. mNGS is superior to conventional microbiological tests for bacterial detection in diabetic patients with pulmonary infections. mNGS is a valuable tool for etiological diagnosis of pulmonary infections in diabetic patients.