The application of metagenomic next-generation sequencing to the diagnosis of causative pathogens of lung
LIANG Chunchan, LE Yisha, LI Haiyan, XU Changfu, YU Gang, WEN Shunhang, LIN Li, ZHANG Hailin, DONG Lin.
Department of Pediatric Respiratory Medicine, the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou
325027, China
Abstract：Objective: To explore the application value of mNGS in the diagnosis of causative pathogens of lung abscesses. Methods: The clinical data and mNGS results of 4 children with lung abscess treated at the respiratory department of our hospital from August 2019 to August 2021 were retrospectively analyzed, and the relevant literature was reviewed. Results: All 4 cases were male, with onset age ranging from 2 month to 11 years presented with symptoms such as cough and fever, with the mean fever duration being 10.5 (range 6-17 d) d; P4 also had dyspnea and chest pain. All 4 cases of lung abscess were diagnosed using chest CT, and P4 had
two pulmonary abscesses. The mNGS analysis identified Streptococcus pneumoniae, Staphylococcus aureus ,prevotella respectively in P1-3 (BALF), and Acinetobacter Johnson and Staphylococcus hominis in P4 (blood).Only P1 (BALF) had bacterial cultures positive for Streptococcus pneumoniae, and the other three patients were negative. All patients improved after intravenous antibiotic therapy with the mean duration being 11.75 (ranging9-14 d) d. They received oral antibiotic therapy (sequential) after discharge. They were followed-up 8-12 weeks, and their chest imaging was normal. Seven articles on the diagnosis of adult lung abscess pathogens by mNGS were retrieved. However, Literature search identified no related literature in pediatric cases or study. Conclusion: With its unique technical advantages, high sensitivity and the ability to detect anaerobic bacteria and rare pathogens, mNGS can provide new means for the diagnosis of causative pathogens of pediatric lung abscesses,which will guide the treatment of clinical antibacterial drugs.
