Performance of metagenomic next-generation sequencing in bronchoalveolar lavage fluid for pathogen detection in patients with acute exacerbations of bronchiectasis

Abstract

This study aimed to evaluate the diagnostic value of metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) in detecting pathogens among bronchiectasis patients with acute exacerbations. A retrospective analysis was conducted on 89 bronchiectasis patients who were treated for acute exacerbations at the First Affiliated Hospital of Ningbo University from April 1, 2021, to September 30, 2023. Among the 89 patients, 88 were diagnosed with pulmonary infection, of which 15.9% (14/88) were cases of mixed infections. The sensitivity of BALF-mNGS for detecting pathogens in bronchiectasis patients during acute exacerbations was significantly higher than that of BALF culture (93.2% vs 28.4%; P < .001). All cases of mixed infection were fully identified by BALF-mNGS. The most common pathogens in patients with bronchiectasis were Pseudomonas aeruginosa, nontuberculous mycobacteria, Haemophilus influenzae, and Aspergillus. In conclusion, compared with the traditional microbial culture method, BALF-mNGS significantly improves the accuracy of diagnosis for detecting pathogens associated with bronchiectasis infections.

Keywords: acute exacerbations; bronchiectasis; bronchoalveolar lavage fluid; metagenomic next-generation sequencing; pathogen.