Related Experiment Video
Updated: Dec 1, 2025
Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
Etiology of Severe Community-Acquired Pneumonia in Adults Based on Metagenomic Next-Generation Sequencing: A
Xiaodong Wu1, Yuanyuan Li2, Ming Zhang3
1Department of Respiratory and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China.
Background:
Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) has the potential to improve the pathogen identification in severe community-acquired pneumonia (SCAP).
Methods:
In this 1.5-year, multicenter, prospective study, we investigated the usefulness of mNGS of BALF for identifying pathogens of SCAP in hospitalized adults, comparing it with other laboratory methods.
Results:
Of 329 SCAP adults, a microbial etiology was established in 304 cases (92.4%). The overall microbial yield was 90.3% for mNGS versus 39.5% for other methods (P < 0.05). The most frequently detected pathogens in immunocompetent patients were Streptococcus pneumoniae (14.8%), rhinovirus (9.8%), Haemophilus influenzae (9.1%), Staphylococcus aureus (8.7%), and Chlamydia psittaci (8.0%), while in immunocompromised patients they were Pneumocystis jirovecii (44.6%), Klebsiella pneumoniae (18.5%), Streptococcus pneumoniae (15.4%), Haemophilus influenzae (13.8%), and Pseudomonas aeruginosa (13.8%). Notably, novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified from two patients solely by mNGS in January 2020; uncommon pathogens including Orientia tsutsugamushi and Nocardia otitidiscaviarum were identified from one patient, respectively. Furthermore, mixed infections were detected in 56.8% of the patients.
Conclusions:
A high microbial detection rate was achieved in SCAP adults using mNGS testing of BALF. The most frequently detected pathogens of SCAP differed between immunocompetent and immunocompromised patients. mNGS testing may be an powerful tool for early identification of potential pathogens for SCAP to initiate a precise antimicrobial therapy.
Insights
Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) significantly improves pathogen identification in severe community-acquired pneumonia (SCAP). This method offers a higher microbial yield compared to traditional techniques, aiding in precise antimicrobial therapy.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Genomics
Background:
- Severe community-acquired pneumonia (SCAP) diagnosis relies on accurate pathogen identification.
- Traditional laboratory methods have limitations in detecting all causative agents of SCAP.
- Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) presents a promising advancement.
Purpose of the Study:
- To evaluate the diagnostic utility of mNGS of BALF for SCAP in hospitalized adults.
- To compare the pathogen detection rate of mNGS with conventional laboratory methods.
- To identify common and uncommon pathogens in SCAP patients, differentiating between immunocompetent and immunocompromised individuals.
Main Methods:
- A 1.5-year, multicenter, prospective study involving hospitalized adults with SCAP.
- Collection and analysis of bronchoalveolar lavage fluid (BALF) using mNGS.
- Comparison of mNGS results with other standard laboratory diagnostic methods.
Main Results:
- A microbial etiology was established in 92.4% of SCAP cases.
- mNGS demonstrated a significantly higher overall microbial yield (90.3%) compared to other methods (39.5%).
- Distinct pathogen profiles were observed in immunocompetent versus immunocompromised patients, with mNGS identifying novel and uncommon pathogens, including SARS-CoV-2.
Conclusions:
- mNGS of BALF achieves a high microbial detection rate in SCAP.
- Pathogen prevalence in SCAP varies between immunocompetent and immunocompromised hosts.
- mNGS is a powerful tool for early and precise pathogen identification in SCAP, guiding antimicrobial therapy.
More Related Videos
11:23Purifying the Impure: Sequencing Metagenomes and Metatranscriptomes from Complex Animal-associated Samples
Published on: December 22, 2014
12:21A Mouse Model for the Transition of Streptococcus pneumoniae from Colonizer to Pathogen upon Viral Co-Infection Recapitulates Age-Exacerbated Illness
Published on: September 28, 2022
Related Concept Videos
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:29Pneumonia II: Pathophysiology
01:30Pneumonia III: Complications and Assessment
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:29Modern Molecular Taxonomy
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....