Analysis of pathogen spectrum of bacterial and fungal coinfections in 291 pulmonary tuberculosis patients based on nanopore sequencing

doi:10.19871/j.cnki.xfcrbzz.2025.06.014

Abstract

Abstract: Objective This study aimed to delineate the pathogen-spectrum characteristics of bacterial and fungal co-infections in pulmonary tuberculosis (PTB) patients by means of third-generation nanopore sequencing,in order to provide scientific basis for the clinical diagnosis and treatment of PTB combined infection. Method A total of 291 PTB patients admitted to the Fourth People's Hospital of Nanning from November 2021 to August 2024 were enrolled. Nanopore sequencing was employed for pathogen profiling. SPSS 26.0 was used to analyse detection rates and seasonal, age- and sample-type distributions with the χ² test. Result The three most frequently detected bacteria were Haemophilus influenzae, Prevotella melaninogenica and Rothia mucilaginosa. Among fungi, Candida albicans, Aspergillus fumigatus, and Pneumocystis jirovecii/Malassezia restricta (tied) predominated. Bacterial infections peaked in spring and summer; the detection rates of the three leading bacteria and A. Fumigatus in spring were significantly higher than in summer (P<0.05). The three main bacteria were more common in patients≤60 years, whereas Candida albicans was more prevalent in those>60 years (P<0.05). Detection rates of the three bacteria in bronchoalveolar-lavage fluid were significantly higher than in puncture tissue, abscess/thoracic fluid or cerebrospinal fluid (P<0.05). Conclusion We identified the core dominant pathogens of bacterial and fungal co-infection in PTB patients.The main types of bacteria are Haemophilus influenzae, Prevotella melaninogenica, and Rothia mucilaginosa; the main types of fungi are Candida albicans, Aspergillus fumigatus, Pneumocystis jirovecii, and Malassezia restricta. Bacterial co-infections are most frequent in spring and summer. Patients aged≤60 years are more prone to the three leading bacterial infections, whereas those>60 years are more susceptible to Candida albicans. For these bacteria, bronchoalveolar-lavage fluid provides the highest detection yield.

Key words: Nanopore sequencing technology, Pulmonary tuberculosis, Fungi, Bacteria, Pathogen spectrum

CLC Number:

R515
521

Zhu Qingdong, Zhao Chunyan, Huang Aichun, Zeng Chunmei, Li Weiwen, Chen Canling, Song Chang. Analysis of pathogen spectrum of bacterial and fungal coinfections in 291 pulmonary tuberculosis patients based on nanopore sequencing[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(6): 87-92.

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