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Diagnostic Insights Into Pathogen Spectrum and Mixed Microbial Detection in Critically Ill Patients With Pulmonary
Hui Zhang1,2, Lin Yang1,2, Zhao Zhao1,2
1Department of Critical Care Medicine, Shangqiu First People's Hospital, Shangqiu, Henan, China.
Canadian Respiratory Journal
|July 25, 2026
Summary
Targeted next-generation sequencing (tNGS) significantly improves pathogen detection in critically ill patients with pulmonary infections compared to conventional methods. This advanced technique offers higher sensitivity and accuracy for identifying diverse microbial culprits, including mixed infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Pulmonary infections pose a significant threat to critically ill patients.
- Conventional microbiological tests (CMTs) have limitations in sensitivity, especially after antibiotic use.
- Targeted next-generation sequencing (tNGS) offers a promising alternative for pathogen detection.
Purpose of the Study:
- To evaluate the pathogen spectrum and mixed infection patterns in critically ill patients using tNGS.
- To compare the diagnostic performance of tNGS against CMTs in this patient population.
Main Methods:
- Retrospective analysis of 217 critically ill patients with suspected pulmonary infection.
- Respiratory specimens were tested using tNGS.
- tNGS results were compared with CMTs using clinical diagnosis as the reference standard.
Main Results:
- tNGS detected microorganisms in 208 of 217 patients, significantly outperforming CMTs.
- A wide range of bacterial, viral, and fungal pathogens were identified, with frequent mixed infections.
- tNGS showed higher sensitivity and accuracy than CMTs, while CMTs had higher specificity.
Conclusions:
- tNGS provides a comprehensive view of pathogens and mixed infections in critically ill patients.
- tNGS offers superior detection rates and sensitivity compared to CMTs.
- Clinical interpretation of tNGS results is crucial for guiding patient care, especially with mixed detections.
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