The clinical utility of bronchoalveolar lavage fluid metagenomic next-generation sequencing in immunocompromised critically ill patients with invasive pulmonary aspergillosis: a multicenter retrospective study

作者：Junjie Zhao, Runxi Zhuge, Kai Guo, Jing Tang, Yong Sun, Yi Zhang, Lingmin Yuan, Canhu Qiu, Youqin Yan, Kaiyu Wang, Qin Jiang, Juan Chen, Zhidan Hua, Liyan Qiu, Honglong Fang, Jiancheng Zhuge · 发表于：Microbiology Spectrum · 年份：2025 · DOI：10.1128/spectrum.00584-25 · 被引用次数：5 · 研究领域：Antifungal resistance and susceptibility、Infectious Diseases and Mycology、Fungal Infections and Studies

ABSTRACT The clinical utility of metagenomic next-generation sequencing (mNGS) in immunocompromised critically ill patients with invasive pulmonary aspergillosis (IPA) remains poorly studied. Given the diagnostic challenges and high mortality associated with IPA in this population, further research on the use of mNGS for early diagnosis and targeted therapy is urgently needed. This multicenter, retrospective, observational study enrolled immunocompromised patients admitted to the intensive care units of six tertiary hospitals in China from April 2021 to November 2024. Comprehensive clinical data were systematically collected, including demographic information, underlying conditions, and detailed records of specimen types and microbiological examination methods. The primary objective was to evaluate the diagnostic and prognostic values of mNGS in comparison to conventional microbiological tests (CMTs) for IPA in this high-risk population. Kappa analysis results indicated a significant agreement between the results of mNGS and CMTs in both groups (Kappa value = 0.638, P < 0.001). The receiver operating curve demonstrated that mNGS exhibited comparable sensitivity (94.03% vs. 95.52%) and higher specificity (96.20% vs. 78.85%), as well as a higher area under the curve (AUC) (0.951 vs. 0.872) in diagnosing IPA compared to CMTs. Moreover, mNGS was significantly superior to other single methods, including cultures (AUC: 0.620, sensitivity: 27.88%, specificity: 96.15%), galactoman...