AUTHOR=Jiang Ziwei , Gai Wei , Zhang Xiaojing , Zheng Yafeng , Jin Xuru , Han Zhiqiang , Ao Geriletu , He Jiahuan , Shu Danni , Liu Xianbing , Zhou Yingying , Hua Zhidan 

TITLE=Clinical performance of metagenomic next-generation sequencing for diagnosis of pulmonary Aspergillus infection and colonization

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=14

YEAR=2024

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2024.1345706

DOI=10.3389/fcimb.2024.1345706

ISSN=2235-2988

ABSTRACT=<sec><title>Background</title><p>Investigations assessing the value of metagenomic next-generation sequencing (mNGS) for distinguish <italic>Aspergillus</italic> infection from colonization are currently insufficient.</p></sec><sec><title>Methods</title><p>The performance of mNGS in distinguishing <italic>Aspergillus</italic> infection from colonization, along with the differences in patients’ characteristics, antibiotic adjustment, and lung microbiota, were analyzed.</p></sec><sec><title>Results</title><p>The abundance of <italic>Aspergillus</italic> significantly differed between patients with <italic>Aspergillus</italic> infection (n=36) and colonization (n=32) (<italic>P</italic> &lt; 0.0001). Receiver operating characteristic (ROC) curve result for bronchoalveolar lavage fluid (BALF) mNGS indicated an area under the curve of 0.894 (95%CI: 0.811-0.976), with an optimal threshold value of 23 for discriminating between <italic>Aspergillus</italic> infection and colonization. The infection group exhibited a higher proportion of antibiotic adjustments in comparison to the colonization group (50% vs. 12.5%, <italic>P</italic> = 0.001), with antibiotic escalation being more dominant. Age, length of hospital stay, hemoglobin, cough and chest distress were significantly positively correlated with <italic>Aspergillus</italic> infection. The abundance of <italic>A. fumigatus</italic> and Epstein-Barr virus (EBV) significantly increased in the infection group, whereas the colonization group exhibited higher abundance of <italic>A. niger</italic>.</p></sec><sec><title>Conclusion</title><p>BALF mNGS is a valuable tool for differentiating between colonization and infection of <italic>Aspergillus</italic>. Variations in patients’ age, length of hospital stay, hemoglobin, cough and chest distress are observable between patients with <italic>Aspergillus</italic> infection and colonization.</p></sec>