宏基因组下一代测序在老年肺部感染中的应用与价值探讨OA

Objective To explore the detection effect of metagenomic next-generation sequencing(mNGS)technology on elderly pulmonary infections.Methods A total of 289 elderly patients aged over 60 years with clinically suspected pulmonary infec-tions admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from July 2021 to December 2023 were selected as study subjects.All patients underwent mNGS of bronchoscopic tracheal aspirates and conventional microbiological tests.The diagnostic per-formance of mNGS and conventional microbiological tests was compared,using clinical diagnostic results as the gold standard.Results Elderly pulmonary infections were predominantly polymicrobial,accounting for 40.5%(117/289).The diagnostic accuracy and sensi-tivity of mNGS were 78.5%and 89.2%respectively,surpassing those of conventional microbiological test(37.4%diagnostic accura-cy,28.8%sensitivity).For the majority of pathogens,the detection rate of mNGS was higher than that of conventional microbiological test.The polymicrobial infection rate in immunocompromised patients was 73.1%(38/52).The pathogen spectrum was also observed to vary among different populations.The positive predictive value was found to depend on the type of pathogen and the patient's immune status.Conclusion In elderly patients with pulmonary infections,polymicrobial infections are the most common.mNGS can greatly improve the accuracy and detection rate of pathogens in elderly patients with pulmonary infections.In addition,when interpreting mNGS results,the comorbidities and types of pathogens should be considered.mNGS has a high clinical application value in the diag-nosis of pulmonary infections in elderly patients.