Comparative Analysis of Metagenomic Next-Generation Sequencing and Conventional Culture for Pathogen Detection in 218 Patients with Pulmonary Infectious Diseases: A Retrospective Study.

BackgroundMetagenomic next-generation sequencing (mNGS) is a promising technique, but comparative studies of mNGS and culture across different pulmonary diseases are limited.MethodsWe retrospectively analyzed data from 218 patients who underwent BALF mNGS testing between November 2021 and April 2025, and patients were categorized into pneumonia, bronchiectasis, NTM, tuberculosis, and other groups based on discharge diagnoses. We compared detection rates, pathogen spectra, co-infection rates, and special pathogen distributions between mNGS and culture. We also assessed concordance (Kappa) and complementary rates.ResultsThe overall positive detection rate of mNGS was significantly higher than that of culture (95.4% vs 67.4%, P