Sequencing Improves Lung Infection Diagnosis

Study of 941 patients highlights how next-generation sequencing can identify difficult-to-detect pathogens and guide antimicrobial treatment

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In a retrospective study of 941 patients with suspected lower respiratory tract infections, both metagenomic and targeted NGS had greater diagnostic yield than conventional microbiological testing.
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Metagenomic NGS sensitivity was 90.6%, compared with 73.4% for targeted NGS, but the methods were evaluated in separate patient groups.
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Targeted NGS identified 54 cases of Mycobacterium tuberculosis, including 42 missed by conventional testing, and detected Pneumocystis jirovecii when silver staining was negative.
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After targeted NGS results, 22.6% of patients required antimicrobial treatment escalation, and 66.2% showed clinical improvement, similar to 66.7% with initially appropriate treatment.
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Both sequencing approaches had low specificity, and the retrospective, single-center study could not establish that sequencing-guided treatment caused improved outcomes.

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