A Paired Comparison of Plasma and Bronchoalveolar Lavage Fluid for Metagenomic Next-Generation Sequencing in Critically Ill Patients with Suspected Severe Pneumonia

Ting Sun,1 Yijie Liu,2 Ying Cai,3 Tianshu Zhai,3 Yun Zhou,4 Bin Yang,5 Xiaojing Wu,3,* Qingyuan Zhan1,3,* 1Capital Medical University China-Japan Friendship School of Clinical Medicine, Beijing, People’s Republic of China; 2Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 3Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People’s Republic of China; 4Laboratory Medicine, China-Japan Friendship Hospital, Beijing, People’s Republic of China; 5Vision Medicals Center for Infection Diseases, Guangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qingyuan Zhan, Capital Medical University China-Japan Friendship School of Clinical Medicine, No. 2 Yinghua East Road, Chaoyang District, Beijing, People’s Republic of China, Tel +86 13911785957, Fax +86 010-64217749, Email drzhanqy@163.com Xiaojing Wu, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, No. 2 Yinghua East Road, Chaoyang District, Beijing, 100029, People’s Republic of China, Tel +86 13811743537, Fax +86 010-64217749, Email xpwxj@163.comPurpose: Plasma metagenomic next-generation sequencing (mNGS) has emerged as an attractive and minimally invasive technique for pathogen detection. However, few studies have demonstrated the need for simultaneous plasma and bronchoalveolar lavage fluid (BALF) mNGS in patients with severe pneumonia.Patients and Methods: This study retrospectively performed a paired comparison of BALF and plasma mNGS in critically ill patients with suspected severe pneumonia from April 2019 to December 2020. The diagnostic performance of BALF and plasma mNGS was compared using the clinical composite diagnosis as the reference