下呼吸道感染宏基因组二代测序报告临床解读路径专家共识

Consensus of clinical pathways of metagenomic next-generation sequencing test in diagnosis of lower respiratory tract infections in China

近年来,宏基因组二代测序(mNGS)技术在下呼吸道感染(LRTI)病原诊断领域得到了广泛应用,国内临床医师在mNGS的临床应用方面已积累了一定的经验和证据。但mNGS在LRTI病原诊断中的适用场景仍缺乏规范,mNGS报告的临床意义解读也缺乏专业的指导意见。本共识基于mNGS在我国LRTI病原诊断方面的应用实践,梳理mNGS在LRTI应用领域的瓶颈问题,汇总本领域专家意见,明确了mNGS在LRTI病原诊断中的适用场景,为mNGS报告临床意义提供了一条合理可行的解读路径,以期规范mNGS在LRTI中科学合理应用。

Metagenomic next-generation sequencing(mNGS)enables sensitive and unbiased detection of all potential pathogens in lower respiratory tract infection(LRTI).But the lack of consensus and uniformity of applicable clinical scenarios and interpretation of results for mNGS largely limit its utilization.To solve these issues,an expert panel including pulmonary physicians,intensivists and microbiologists is organized by Chinese Thoracic Society.The panel conducted a systematic review of progress and challenges regarding the application of mNGS on etiological diagnosis of LRTI.The panel formulated 17 specific recommendations spanning questions of suitable clinical situations,sample quality control,process of reports interpretation and subsequent medical decisions.Hopefully,this consensus can provide practical guidelines for clinicians and promote the rational application of mNGS in LRTI.