The application of mNGS of bronchoalveolar lavage fluid in dissecting pulmonary infections in patients with CTD-ILD.

Objectives To evaluate the application of metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) in the diagnosis of pulmonary infection in patients with connective tissue disease-associated interstitial lung disease (CTD-ILD). Methods Patients with CTD-ILD who had been...

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Published in:Rheumatology Vol. 65; no. 2; pp. 1 - 11
Main Authors: Yu, Hang, Xu, Yanxiao, Chen, Die, Gong, Muxue, Sun, Wenjia, Liu, Mengdan, Zhang, Ting, Xue, Jing
Format: research tables/charts Journal Article
Published: Oxford University Press / USA Feb2026
Online Access:View this record in EBSCOhost
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      dt: Feb2026
      vid: 65
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      pub: Oxford University Press / USA
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        10.1093/rheumatology/keaf571
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        atl: The application of mNGS of bronchoalveolar lavage fluid in dissecting pulmonary infections in patients with CTD-ILD.
      aug:
        au:
          Yu, Hang
          Xu, Yanxiao
          Chen, Die
          Gong, Muxue
          Sun, Wenjia
          Liu, Mengdan
          Zhang, Ting
          Xue, Jing
        affil: Department of Rheumatology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
      sug:
        subj:
          Sequence Analysis
          Bronchoalveolar Lavage
          Lung Diseases, Fungal
          Connective Tissue Diseases Complications
          Lung Diseases, Interstitial
          Human
          Funding Source
          Male
          Female
          Middle Age
          Aged
          Retrospective Design
          Record Review
          T-Tests
          Wilcoxon Rank Sum Test
          Chi Square Test
          Pearson's Correlation Coefficient
          Fisher's Exact Test
          Spearman's Rank Correlation Coefficient
          ROC Curve
          Microbiological Techniques
          Cytomegaloviruses
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Objectives To evaluate the application of metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) in the diagnosis of pulmonary infection in patients with connective tissue disease-associated interstitial lung disease (CTD-ILD). Methods Patients with CTD-ILD who had been evaluated for suspected pulmonary infection by mNGS of BALF were identified, and were then categorized either as pulmonary infection or non-infectious disease progression of CTD-ILD based on clinical composite assessment. The performance of mNGS in the diagnosis of pulmonary infection was compared with that of conventional microbiological tests (CMTs). Results In the 48 patients with CTD-ILD who had been evaluated for pulmonary infection by mNGS of BALF, the majority (66.67%) were patients with idopathic inflammatory myopathy-associated ILD (IIM-ILD). According to the clinical composite assessment, 36 patients were classified as pulmonary infection and 12 as non-infectious disease progression. Cytomegalovirus (CMV), Pneumocystis jirovecii and aspergillus were among the most common causative pathogens. While mNGS was superior in identifying bacteria, viruses and P. jirovecii , CMTs identified more aspergillus and cryptococcus. Decreased albumin, reduced immunoglobulin M and increased lactate dehydrogenase (LDH) were predictors for pulmonary infections in CTD-ILD. Short disease duration, decreased lymphocytes and reduced immunoglobulins were predictive of infection with P. jirovecii. Older age and increased serum ferritin were more common in patients with aspergillus infection. Conclusion Pulmonary infections are common in patients with CTD-ILD. mNGS has the advantages of rapidly detecting more bacteria, viruses and P. jirovecii. However, infection with aspergillus should be more rigorously evaluated in combination with CMTs.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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