Clinical utility of metagenomic next-generation sequencing negative results in corticosteroid-responsive diffuse parenchymal lung diseases

<bold>OBJECTIVES:</bold> To explore the clinical utility of mNGS negative results in the medication modification for corticosteroid-responsive diffuse parenchymal lung disease (DPLD) patients <bold>DESIGN:</bold> retrospective, descriptive study. <bold>SETTING:</bold> 10 Respiratory and Critical Care Departments in the Jiangsu Province in China <bold>PATIENTS:</bold> Adult patients (≥18 yr) admitted to the 10 Respiratory and Critical Care Departments for corticosteroid-responsive DPLD from January 1, 2020, to December 31,2022 <bold>INTERVENTIONS:</bold> None. <bold>RESULTS:</bold> In this retrospective study involving 41 patients, following negative mNGS reports, 79.4% patients downgraded antibiotics, 63.4% patients initiated corticosteroid administration, and 7.3% patients increased corticosteroid dosages. Patients with Oxygenation Index below 300 exhibited high detection rate of Pseudomonas, Corynebacterium, Staphylococcus, and Stenotrophomonas, while Porphyromonas was rarely detected. Patients with pleural effusion showed high abundance of Escherichia and Stenotrophomonas, as well as low abundance of Streptococcus. The microbiota detected by mNGS could imply the varing severity of the disease. <bold>CONCLUSIONS:</bold> Our findings demonstrated the clinical significance of mNGS in assisting the antibiotic and corticosteroid treatment adjustment in corticosteroid-responsive DPLD. Lung microbiota may imply the severity of the disease.