Pneumocystis jirovecii pneumonia (PJP) is difficult to be diagnosed, so this study explored if PJP could be diagnosed by metagenomic next-generation sequencing (mNGS) and if mNGS could guide the therapy of PJP. mNGS was successfully diagnosed 13 out of 14 PJP recipients with 11 through peripheral blood samples, verified by PCR. Ten non-PJP recipients were enrolled as the control group. Blood tests revealed a high β-D-glucan (BDG) level in all recipients with PJP during the hospitalization. Four (28.6%) of 14 PJP patients were infected with cytomegalovirus simultaneously, while 8 (57.1%) suffered from a combined infection caused by Torque teno virus. Five (35.7%) of 14 cases died of PJP or the subsequent bacteremias/bacterial pneumonia with a longer interval between the onset and diagnosis of/the available therapy against PJP than survival cases. Univariate analysis of characteristics between PJP and non-PJP recipients revealed that BDG assays was higher at the admission in PJP group (P =0.011). This present study supports the value of mNGS detection of blood sample in diagnosing PJP, which could assist clinical decision for therapy against PJ and improve outcome of PJP. The study also highlights the sensitivity of BDG assays. Cytomegalovirus and Torque teno virus infections often occur at the same time of PJP, thus can be alerts of PJP.

耶氏肺孢子菌 肺炎 (PJP) 难以诊断，因此本研究探讨是否可以通过宏基因组二代测序 (mNGS) 诊断 PJP，以及 mNGS 是否可以指导 PJP 的治疗。mNGS 通过外周血样本成功诊断出 14 名 PJP 接受者中的 13 名，其中 11 名经 PCR 验证。十名非 PJP 接受者被登记为对照组。血液检查显示住院期间所有 PJP 受者的 β-D-葡聚糖 (BDG) 水平较高。14 名 PJP 患者中有 4 名（28.6%）同时感染了巨细胞病毒，8 ​​名（57.1%）同时感染了 Torque Teno 病毒。14 例中有 5 例 (35.7%) 死于 PJP 或随后的菌血症/细菌性肺炎，与存活病例相比，PJP 的发病和诊断/可用治疗之间的间隔更长。P = 0.011）。本研究支持血液样本的 mNGS 检测在诊断 PJP 中的价值，这有助于临床决策治疗 PJ 并改善 PJP 的结果。该研究还强调了 BDG 检测的灵敏度。巨细胞病毒和Torque Teno病毒感染常与PJP同时发生，可作为PJP的警示。