Comparison of next-generation sequencing with traditional methods for pathogen detection in cases of lower respiratory tract infection at a community hospital in Eastern China

The first case report: diagnosis and management of necrotizing fusobacterium lung abscess via BALF next-generation sequencing

BACKGROUND

Fusobacterium necrophorum (F. necrophorum)-induced necrotizing pneumonia is a rare but severe pulmonary infection. Insufficient microbiological detection methods can lead to diagnostic difficulties.

METHODS

We report a case of F. necrophorum lung abscess diagnosed by next-generation sequencing (NGS) of bronchoalveolar lavage fluid (BALF).

RESULTS

BALF-NGS detected F. necrophorum, guiding subsequent targeted antibiotic therapy. With active drainage and metronidazole treatment, the patient's condition was effectively treated.

CONCLUSION

BALF-NGS is a valuable tool for the rapid diagnosis of infections caused by difficult-to-culture bacteria. It played a decisive role in the early identification of F. necrophorum, enabling timely and targeted antibiotic intervention. Early diagnosis and appropriate treatment are crucial for the management of F. necrophorum pneumonia.

Detection of respiratory pathogenic bacterial nucleic acid detection by Loop-mediated Isothermal Amplification in patients with bacterial pulmonary infections

Objective

Nucleic acid testing can accurately and rapidly identify the presence of pathogenic bacteria. In this study, we analyzed respiratory pathogenic bacteria nucleic acids by LAMP (Loop-mediated isothermal amplification) to clarify the clinical application in patients with bacterial pulmonary infections.

Methods

Clinical data and specimens were collected from 99 patients with bacterial pulmonary infections from June 2021 to April 2023. We compared the differences between nucleic acid detection of LAMP and sputum culture. The correlation between inflammation manifestations of pulmonary imaging and the nucleic acid detection of LAMP was compared and analyzed. And the relationship between LAMP and blood inflammatory markers were analyzed.

Results

The positive rate of LAMP using sputum specimens was significantly higher than that of sputum culture (P < 0.05). Pathogenic bacteria in sputum samples are more likely to be detected by LAMP in patients with inflammatory on lung imaging examination. The coincidence rate of elevated PCT and CRP expression with positive LAMP results were 83.87 % and 88.71 %, respectively. Moreover, PCT, CRP and WBC were significantly higher in LAMP positive group than those in negative group (P < 0.05).

Conclusion

Nucleic acid testing of sputum specimens for pathogenic bacteria by LAMP on the basis of imaging examination can provide a rapid and accurate experimental basis for clinical diagnosis of bacterial pulmonary infections.