The Utility of Metagenomic Next-Generation Sequencing (mNGS) in the Management of Patients With Bronchiectasis: A Single-Center Retrospective Study of 93 Cases

Abstract

Bronchiectasis is a chronic inflammatory respiratory disease mainly caused by pathogenic infections. However, standard methods of pathogens detection show prolonged cycle durations, and unsatisfactory sensitivity and detection rates. Macrogenomic next-generation sequencing (mNGS) emerges as a promising technique for swift, effective, and unbiased pathogen detection and subsequent data interpretation. Here, a retrospective analysis of 93 patients with suspected bronchiectasis was performed to assess the clinical applicability of mNGS. Bronchoalveolar alveolar lavage fluid (BALF) samples were collected from these subjects, followd by performing standard assays and mNGS separately. The turnaround time, detection rate, and pathogen identification using mNGS were compared with those of standard methods. Results showed that mNGS identified a greater number of bacteria (72 vs. 16), fungi (26 vs. 19), and viruses (14 vs. 0) than standard methods. Specifically, the commonly identified bacteria were Haemophilus, Mycobacterium intracellulare, Pseudomonas, and Streptococcus pneumoniae, while the most detected fungi were Aspergillus and the most prevalent viruses were human herpes viruses. Of note, 29 out of 30 patients (96.67%) who received optimized treatment strategies based on mNGS results experienced recovery. Collectively, these findings suggest that mNGS has the potential to improve the diagnosis and treatment of bronchiectasis patients by enabling rapid and precise pathogen detection, which can lead to timely and effective treatment strategies.

Microbiological characteristics of the lower airway in adults with bronchiectasis: a prospective cohort study

“…Therefore, lower respiratory tract samples such as BALF are more ideal samples for pathogen identification, while BALF has low microbial biomass and requires higher technical requirements for the operators. Here, we collected BALF samples to identify microbial characteristics in the lower airways in bronchiectasis via mNGS, which has been widely used to rapidly and precisely detect pathogens in patients with lower respiratory tract infection and bronchiectasis [ 10 , 24 ]. Consistently, mNGS yielded superior sensitivity, specificity and accuracy compare with CMTs.…”

The Respiratory Microbiome in Paediatric Chronic Wet Cough: What Is Known and Future Directions

“…Diagnostic testing of respiratory microbiology remains broadly reliant on culture and/or PCR-based tests; however, culture can lack sensitivity and PCR-based methods target only a small number of species [ 28 , 60 , 128 ]. The availability of real-time DNA sequencing technology heralds a new era of diagnostic applications [ 129 ]; however, translation into microbiome-based tests has yet to be realised. As discussed above, diagnostic respiratory endotyping is likely to require integration of microbial and host response data (either transcriptomic data or targeted quantification of immune biomarkers).…”

A single-center, retrospective study of hospitalized patients with lower respiratory tract infections: clinical assessment of metagenomic next-generation sequencing and identification of risk factors in patients

“…The detection of herpesviruses is exceedingly common in mNGS reports. Notably, species from the herpesvirus family, including Epstein-Barr virus (EBV), cytomegalovirus (CMV), and herpes simplex virus, are the most commonly identified viruses in these studies [ 16 , 17 ]. Herpesviruses can induce pulmonary diseases in respiratory tract infections, particularly in immunocompromised individuals.…”

“…Herpesviruses can induce pulmonary diseases in respiratory tract infections, particularly in immunocompromised individuals. Furthermore, they have been linked to the development and advancement of bronchiectasis, potentially via alternative biological pathways like telomere depletion and cell senescence [ 16 ]. Herpes viruses can induce pulmonary diseases in respiratory tract infections, particularly in immunocompromised individuals.…”