Antimicrobial strategies of Lower Respiratory Tract Infection in Immunocompromised Patients based on Metagenomic Next-Generation Sequencing：a retrospective study

Antimicrobial strategies of Lower Respiratory Tract Infection in Immunocompromised Patients based on Metagenomic Next-Generation Sequencing：a retrospective study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Antimicrobial strategies of Lower Respiratory Tract Infection in Immunocompromised Patients based on Metagenomic Next-Generation Sequencing：a retrospective study Beibei Meng, Haichao Liu, Qinliang Wu, Lei Qu, Congzheng Mao, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4998139/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 14 Mar, 2025 Read the published version in BMC Infectious Diseases → Version 1 posted 11 You are reading this latest preprint version Abstract Background Immunocompromised patients with Lower Respiratory Tract Infection(LRTI) frequently encounter a diverse range of pathogenic infections, characterized by rapid disease progression and significant mortality rates due to reckless or excessive utilization of antibiotics. Therefore, it is crucial to promptly and accurately identify the causative microorganisms for pathogen diagnosis and clinical decision-making. The objective of this study is to evaluate the clinical applicability of metagenomic next-generation sequencing (mNGS) in the diagnosis and management of LRTI, as well as its impact on empirical antibacterial therapy for patients with varying immune statuses. Methods We conducted a comparative analysis of positivity rate, detection accuracy, pathogen spectrum, duration of treatment (DOT), and antibiotic management in a cohort of 283 patients diagnosed with lower respiratory tract infections. Results The positive detection rate was higher in mNGS compared to conventional culture in both immunocompetent group (89.92% vs. 28.57%, P < 0.001) and immunocompromised group (84.44% vs. 33.33%, P < 0.001). The antibiotic escalation in the immunocompromised group was more frequent than that in the immunocompetent group (49.00% vs. 31.00%, P = 0.018), but no difference was observed for antibiotic de-escalation (20.00% vs. 15.00%, P = 0.458). Conclusions The application of mNGS can significantly enhance the pathogen detection rate and optimize antimicrobial drug management in immunocompromised patients with LRTI. lower respiratory tract infections (LRTI) pathogen identification metagenomic next-generation sequencing (mNGS) immune status antibiotic management Full Text Additional Declarations No competing interests reported. Supplementary Files supplementarymaterials.docx Cite Share Download PDF Status: Published Journal Publication published 14 Mar, 2025 Read the published version in BMC Infectious Diseases → Version 1 posted Editorial decision: Revision requested 14 Jan, 2025 Reviews received at journal 24 Dec, 2024 Reviews received at journal 21 Dec, 2024 Reviewers agreed at journal 20 Dec, 2024 Reviewers agreed at journal 18 Nov, 2024 Reviews received at journal 30 Sep, 2024 Reviewers agreed at journal 03 Sep, 2024 Reviewers invited by journal 30 Aug, 2024 Editor assigned by journal 30 Aug, 2024 Submission checks completed at journal 30 Aug, 2024 First submitted to journal 29 Aug, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4998139","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":352653160,"identity":"80962c08-705a-43b5-b2b8-9154ccf8383c","order_by":0,"name":"Beibei Meng","email":"","orcid":"","institution":"Wuhan University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Beibei","middleName":"","lastName":"Meng","suffix":""},{"id":352653161,"identity":"fc1b3f67-a10f-42da-bedd-11e9d54a0db6","order_by":1,"name":"Haichao Liu","email":"","orcid":"","institution":"General Hospital of Center Theater of 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Therefore, it is crucial to promptly and accurately identify the causative microorganisms for pathogen diagnosis and clinical decision-making. 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The antibiotic escalation in the immunocompromised group was more frequent than that in the immunocompetent group (49.00% vs. 31.00%, P\u0026thinsp;=\u0026thinsp;0.018), but no difference was observed for antibiotic de-escalation (20.00% vs. 15.00%, P\u0026thinsp;=\u0026thinsp;0.458).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe application of mNGS can significantly enhance the pathogen detection rate and optimize antimicrobial drug management in immunocompromised patients with LRTI.\u003c/p\u003e","manuscriptTitle":"Antimicrobial strategies of Lower Respiratory Tract Infection in Immunocompromised Patients based on Metagenomic Next-Generation Sequencing：a retrospective study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-09-30 17:49:16","doi":"10.21203/rs.3.rs-4998139/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-01-14T09:08:22+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-12-24T09:08:05+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-12-21T11:34:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"209997318064323743933436908881849958891","date":"2024-12-20T22:51:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"319702797138008843142177596026402196930","date":"2024-11-18T13:19:11+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-09-30T14:13:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"263234396035281611265438067632676606826","date":"2024-09-03T14:41:24+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-08-31T01:13:26+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-08-30T15:50:04+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-08-30T05:15:11+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Infectious Diseases","date":"2024-08-29T13:38:28+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f49265fc-6798-44f2-8791-405069220c99","owner":[],"postedDate":"September 30th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-03-17T16:04:42+00:00","versionOfRecord":{"articleIdentity":"rs-4998139","link":"https://doi.org/10.1186/s12879-025-10753-5","journal":{"identity":"bmc-infectious-diseases","isVorOnly":false,"title":"BMC Infectious Diseases"},"publishedOn":"2025-03-14 15:58:30","publishedOnDateReadable":"March 14th, 2025"},"versionCreatedAt":"2024-09-30 17:49:16","video":"","vorDoi":"10.1186/s12879-025-10753-5","vorDoiUrl":"https://doi.org/10.1186/s12879-025-10753-5","workflowStages":[]},"version":"v1","identity":"rs-4998139","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4998139","identity":"rs-4998139","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}