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Background: This study aimed to compare the results of metagenomic next-generation sequencing (mNGS) and conventional culture detection of pathogenic bacteria in bronchoalveolar lavage fluid (BALF) of patients with respiratory tract infections and analyze the influencing factors and clinical significance of mNGS positive detection.
Methods: We retrospectively analyzed BALF samples from 90 respiratory infection patients at the First People's Hospital of Yongkang City from June 1, 2024, through January 28, 2025, using mNGS and conventional culture testing to compare the positivity rate, pathogen distribution, and consistency of the two methods. The relationship between mNGS detection positivity and clinical indicators of patients and patient prognosis was analyzed.
Results: The positive rate of mNGS detection was 77.78%, while the positive rate of conventional culture detection was 44.44%, and the difference was statistically significant (p < 0.05). mNGS can detect a wider variety of pathogens, mainly gram-negative bacilli, fungi, and atypical pathogens. mNGS has moderate consistency with conventional culture detection results in bacteria, fungi, and atypical pathogens, but low consistency in viruses and para-sites. The positive detection of mNGS is related to factors such as patient age, underlying diseases, peripheral blood white blood cells, and C-reactive protein, which are risk factors affecting the positive detection of mNGS.
Conclusions: The pathogenic diagnosis of mNGS in BALF of patients with lower respiratory tract infections is su-perior to conventional culture detection; it can detect more and a wider range of pathogens, helping to promote rational drug use and improve patient prognosis in clinical practice.
DOI: 10.7754/Clin.Lab.2025.250525
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