metagenomic data that revealed the capacity of mNGS in the microbiological characteristics in the lower airway of bronchiectasis patients

Microbial infection and colonization are the vital components of bronchiectasis pathophysiology, which are always associated with worsened clinical outcomes, including declined lung function and increased exacerbation rate. The identification of pathogens is a crucial step in achieving precise and effective treatments during bronchiectasis exacerbation. We conducted a prospective observational cohort study involving patients with bronchiectasis exacerbation at the First Affiliated Hospital of Guangzhou Medical University. We obtained bronchoalveolar lavage fluid (BALF) samples for microbiological analysis using both conventional microbiological tests (CMTs) and metagenomic Next-Generation Sequencing (mNGS). Out of 168 patients, 141 patients were found to have definite or probable pathogens identified using metagenomic Next-Generation Sequencing (mNGS). When compared to conventional microbiological tests (CMTs), mNGS showed a higher detection rate for the top 5 pathogens in our cohort: Pseudomonas aeruginosa, Nontuberculous mycobacteria (NTM), Haemophilus influenzae, Nocardia spp, and Staphylococcus aureus. Additionally, mNGS exhibited greater sensitivity and specificity. Furthermore, we observed strong correlations between Pseudomonas aeruginosa, Haemophilus influenzae, Nontuberculous mycobacteria with disease severity, highlighting the significant role of these pathogens in the progression of bronchiectasis.