Analysis of the microbial profile of bronchoalveolar lavage fluid in patients with pulmonary tuberculosis complicated by lower respiratory tract infection using metagenomic sequencing

doi:10.19871/j.cnki.xfcrbzz.2026.04.001

Abstract

Abstract: Objective To investigate the microbial profiling characteristics of bronchoalveolar lavage fluid (BALF) in patients with pulmonary tuberculosis complicated by lower respiratory tract infection (PTB-LRTI), and to preliminarily elucidate the potential mechanisms of microbiota involvement in the disease, thereby providing a theoretical basis for the diagnosis of PTB-LRTI. Method BALF samples were collected from 98 patients treated at Gansu Provincial People's Hospital from June 2023 to December 2024, including 60 patients in the PTB-LRTI group and 38 patients in the LRTI group. Metagenomic next-generation sequencing (mNGS) was employed to analyze the microbial composition of BALF. The microbial community structure and functional differences between the two groups were compared using α-diversity analysis, linear discriminant analysis effect size (LEfSe) analysis, and Kyoto encyclopedia of genes and genomes CCCCCC(KEGG) functional annotation. Result Compared with the LRTI group, the PTB-LRTI group showed significantly higher α-diversity of the BALF microbial profile (P<0.05). The abundances of Firmicutes, Actinobacteria, and Bacteroidetes were increased in the PTB-LRTI group, with significant enrichment of Mycobacterium, Nocardia, Mycobacterium tuberculosis, and Nocardia farcinica. In the LRTI group, Proteobacteria, as well as Streptococcus, Klebsiella, and Haemophilus, were predominantly enriched. The number of species identified in the PTB-LRTI group was higher than that in the LRTI group (396 vs. 145 species). LEfSe analysis revealed significant differences between the two groups at multiple taxonomic levels. KEGG functional analysis showed significant differences in terpenoid backbone biosynthesis, cyclic adenosine monophosphate signaling pathway, and phosphonate biosynthesis between the two groups (P<0.05). Conclusion The BALF microbial community structure and functional profiles in patients with PTB-LRTI are significantly altered, characterized by enrichment of Firmicutes, Actinobacteria, and Mycobacterium. The differential microbiota are associated with disturbances in metabolic functions, including terpenoid backbone biosynthesis, suggesting that BALF microbial profiling analysis may provide a novel theoretical basis for the etiological diagnosis and mechanistic research of PTB-LRTI.

Key words: Tuberculosis, Lower respiratory tract infection, Metagenomic next-generation sequencing, Bronchoalveolar lavage fluid, Microbial profiles

CLC Number:

R446

Liu Yu, Tang Junxia, Zhao Qianqian, Liu Zonglin, Jia Lina, Tian Yueyou, Hu Weidong. Analysis of the microbial profile of bronchoalveolar lavage fluid in patients with pulmonary tuberculosis complicated by lower respiratory tract infection using metagenomic sequencing[J]. Electronic Journal of Emerging Infectious Diseases, 2026, 11(4): 1-12.

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