Objective  To investigate the application value of next-generation sequencing (NGS) technology in the etiological diagnosis of community-acquired pneumonia (CAP).

Methods  A retrospective study was conducted to analyze the clinical data of 64 patients with CAP whose alveolar lavage fluid samples were collected by bronchoscopy from Department of Respiratory and Critical Care Medicine, Wuhan Central Hospital from December 2020 to August 2021 for NGS examination, and to compare the differences between NGS technology and other traditional etiological detection methods in the diagnosis of pathogens in patients with CAP.

Results  Among 64 patients with alveolar lav-age fluid NGS, 55 cases were positive and 9 cases were negative. In NGS, 27 bacterial species were detected in 41 pa-tients, and 6 bacteria were detected in 17 patients with traditional bacterial culture, and the detection rate of NGS bacteria was significantly higher than that of unified bacterial culture (64.1% vs. 26.6%, P<0.001). There were 27 patients with NGS and 31 cases with traditional fungal culture, and there was no significant difference between the detection rates of NGS fungi and traditional fungal culture (48.4% vs. 42.2%, P=0.48). NGS detected virus in 29 cases, Legionella pneumophila in 1 case, chlamydia pti in 2 cases, Mycobacterium tuberculosis in 6 cases, and mycoplasma and chlamydia were not detected. Traditional etiological tests detected virus in 2 cases, Mycobacterium tuberculosis in 4 cases, chlamydia pneumonia in 2 cases, Chlamydia pti, Legionella pneumophila, and mycoplasma pneumoniae were not detected.

Conclusion  NGS can be used for the detection of atypical pathogens such as bacteria, fungi and viruses at the same time. Compared with traditional pathogen detection methods, NGS can detect a wide range of pathogenic microorganisms with rich species, which is of great significance in the etiological diagnosis of patients with community-acquired pneumonia. However, pathogens detected by NGS need to be combined with clinical analy-sis to determine whether they are pathogenic bacteria.

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