OBJECTIVE To explore the clinical value of metagenomic next generation sequencing (mNGS) in detection of pathogens from the patients with pulmonary infection.

METHODS The clinical data were collected from 103 patients with pulmonary infection who were treated in respiratory and critical care medicine department of Gansu Province People′s Hospital from Jun. 2021 to Jun. 2023. The pathogens were detected from all of the patients with the use of mNGS for bronchoalveolar lavage fluid (BALF) and traditional cultures (including sputum culture and BALF culture). The positive rates, consistency, distribution, efficacy and curative effects were observed and systematically compared between the two detection methods.

RESULTS Totally 122 strains of bacteria, 47 strains of fungi, 94 strains of viruses, 3 strains of Mycoplasma and 2 strains of Chlamydia were detected from the 103 patients by mNGS, as compared with only 45 strains of bacteria and 20 strains of fungi that were detected by the traditional culture method. The positive rate of detection of pathogens was 89.32% by mNGS, higher than 38.83% of the traditional culture method (P < 0.001). There was certain difference in the distribution of pathogens between the two detection method, the two detection method showed the poor consistency of detection efficacy, and the effect of targeted drug therapy based on the mNGS-detected pathogens was higher than that of the mNGS-negative empirical therapy (P < 0.001). In addition, some of drug resistance genes could be detected by mNGS.

CONCLUSIONS The mNGS shows remarkable higher efficacy in detection of the pathogens causing pulmonary infections than the traditional culture method and can detect various types of pathogens. The effect of the targeted drug therapy based on the pathogens detected by mNGS is remarkable. It plays an imorptant role in guiding the clinical diagnosis and treatment of the patients with pulmonary infections.