■为了评估宏基因组下一代测序（mNGS）对肺孢子虫肺炎（PCP）的诊断性能，与聚合酶链反应（PCR）相比，Gomori亚甲基胺银(GMS)染色和血清1,3-β-d-葡聚糖(BG)测定。
■纳入52例PCP患者和103例非肺囊性Jirovecii肺炎（非PCP）患者，并对不同诊断试验进行比较分析。对临床特征和共同病原体特征进行了综述。
■与PCR相比，mNGS的诊断灵敏度（92.3％）和特异性（87.4％）没有显着差异，而mNGS在检测中具有优于PCR的优势。共同病原体。尽管其优异的特异性，GMS染色的灵敏度(9.3%)低于mNGS(p<.001)。在接受者工作特征曲线下的区域中，mNGS与血清BG的组合在统计学上优于mNGS或单独的血清BG（AUCs，分别为p=.0013和p=.0015)。值得注意的是,所有显示jirovecii肺孢子虫mNGS阳性的血液样本均来自PCP患者.PCP患者中主要的共同病原体是巨细胞病毒，EB病毒和TorqueTeno病毒。
■mNGS在疑似PCP的诊断中显示出优于几种常用临床方法的优势。血清BG联合mNGS进一步提高了mNGS的诊断效能。
To evaluate diagnostic performance of metagenomic next-generation sequencing (mNGS) for Pneumocystis jirovecii pneumonia (PCP), in comparison with polymerase chain reaction (PCR), Gomori methenamine silver (GMS) staining and serum 1,3-β-d-Glucan (BG) assay.
52 PCP patients and 103 patients with non-pneumocystic jirovecii pneumonia (non-PCP) were enrolled, and comparative analysis was conducted of different diagnostic tests. Clinical features and co-pathogen characteristics were reviewed.
The diagnostic sensitivity (92.3%) and specificity (87.4%) of mNGS did not show significant differences compared with that of PCR while mNGS had the advantage over PCR in the detection of co-pathogens. Despite its excellent specificity, the sensitivity of GMS staining (9.3%) was inferior to that of mNGS (p < .001). The combination of mNGS with serum BG statistically outperformed mNGS or serum BG alone in the areas under the receiver operating characteristic curves (AUCs, p = .0013 and p = .0015, respectively). Notably, all the blood samples showing positive mNGS for Pneumocystis jirovecii came from PCP patients. The leading co-pathogens among patients with PCP were cytomegalovirus, Epstein-Barr virus and Torque teno virus.
mNGS shows superiority over several common clinical methods in the diagnosis of suspected PCP. Serum BG in conjunction with mNGS further improved the diagnostic efficacy of mNGS.
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