Performance of broad-spectrum targeted next-generation sequencing in lower respiratory tract infections in ICU patients: a prospective observational study

作者：Chuanxi Chen, Ruizhi Wang, Bilin Wei, Yili Chen, Dejian Gu, Jianmin Xu, Huifang Zheng, Zhe Xu, Linfang Ding, Xiaonan Chen, Li-Hua Xiao, Liping Bai, Zimeng Liu, Yongjun Liu, Minying Chen, Peisong Chen, Xiangdong Guan, Jianfeng Wu · 发表于：Critical Care · 年份：2025 · DOI：10.1186/s13054-025-05470-z · 被引用次数：14 · 研究领域：Nosocomial Infections in ICU、Pneumocystis jirovecii pneumonia detection and treatment、Antibiotic Resistance in Bacteria

PURPOSE: Targeted next-generation sequencing (tNGS) has emerged as an advanced diagnostic technique. While tNGS is increasingly recognized as a valuable tool for detecting infections, its most relevant clinical indications remain underdefined. This study aimed to evaluate the clinical utility of tNGS for lower respiratory tract infections (LRTIs). METHODS: We conducted a prospective, observational study to evaluate the clinical diagnostic value of broad-spectrum targeted Next-Generation Sequencing (bstNGS) covering 1872 microorganisms in critically ill patients with LRTIs. We compared the microbial detection performance of bstNGS, mNGS, and traditional culture methods in bronchoalveolar lavage fluid (BALF). Additionally, we used the odds ratio (OR) from multiple logistic regression to assess the impact of relevant clinical variables on the detection of pathogens by bstNGS. We also examined the correlation between bstNGS pathogen detection results and clinical outcomes. RESULTS: Between August 23, 2023, and April 24, 2024, samples from 150 patients were analyzed. bstNGS detected 96.33% and 91.15% of the microorganisms discovered by mNGS and culture respectively, and was capable of identifying microorganisms with even lower loads. According to the diagnostic criteria, bstNGS, mNGS, and culture methods detected pathogens in 87.33%, 82.00%, and 46.00% of the samples respectively. Moreover, the NGS methods demonstrated a stronger pathogen detection ability compared to culture (p <...