The diagnostic value of plasma microbial cell-free DNA sequencing in pulmonary infections / 中华检验医学杂志

ABSTRACT

Based on metagenomic next-generation sequencing (mNGS), sequencing of plasma microbial cell-free DNA (mcfDNA) has recently been shown to provide a non-invasive pathogenic diagnostic technique for infectious diseases. In sepsis and bloodstream infections, mcfDNA sequencing has advantages in sensitivity, timeliness, and pathogen coverage compared with traditional pathogenic diagnostic techniques such as blood culture, according to available research results. However, the sensitivity of mcfDNA is much lower than that of mNGS with high-quality lower respiratory tract (LRT) specimens such as bronchoalveolar lavage fluid in pulmonary infections, and high-quality clinical research is still unavailable. Therefore, mcfDNA sequencing should not be used as a first-line etiological method for pulmonary infection and should only be used in patients with severe infection in whom pathogens cannot be identified by classical etiological methods and high-quality LRT specimens are not available for microbial mNGS. In order to improve the sensitivity of mcfDNA and to identify the most suitable patients as well as the best time of its application in pulmonary infections, the optimization of these testing techniques is urgently needed.