Division of Infectious Diseases, Department of Pediatrics, Children's Hospital Los Angeles.
Keck School of Medicine at the University of Southern California.
Curr Opin Pediatr. 2018 Feb;30(1):125-130. doi: 10.1097/MOP.0000000000000577.
With the advent of novel massively parallel sequencing technologies and bioinformatic processing capabilities, clinical applications of metagenomic studies are rapidly being integrated into medicine. Through this paper, we hope to introduce this powerful new tool to clinicians caring for children.
Very few studies have looked at metagenomic applications in children. The ability to perform these types of massive sequencing projects was not possible as little as 7 years ago.
Metagenomics is defined as the study of all genetic material within a given sample. Novel sequencing and analysis approaches allow for unbiased assays to identify pathogens missed by targeted sequencing and culture methods. Although not widely available yet, metagenomic studies have been used to diagnose pediatric infections, identify resistance genes in clinical samples, and characterize outbreaks. Although cost and turnaround time have limited its application in clinical laboratories to date, novel platforms and increasing comfort with these techniques continue to push diagnostic metagenomics into clinical pediatric medicine. Much work in this field is yet to be done. That being said, we feel that pediatric clinicians will be using metagenomic techniques in the care of children with increasing frequency in the near future.
随着新型高通量测序技术和生物信息处理能力的出现,宏基因组研究的临床应用正在迅速融入医学领域。通过本文,我们希望向儿科护理的临床医生介绍这一强大的新工具。
很少有研究关注宏基因组在儿童中的应用。就在 7 年前,还不可能进行这种类型的大规模测序项目。
宏基因组学被定义为对给定样本中所有遗传物质的研究。新型测序和分析方法允许进行无偏检测,以识别靶向测序和培养方法遗漏的病原体。虽然尚未广泛应用,但宏基因组研究已被用于诊断儿科感染,鉴定临床样本中的耐药基因,并描述暴发情况。尽管成本和周转时间限制了其在临床实验室中的应用,但新型平台和对这些技术的日益熟悉继续将诊断宏基因组学推向临床儿科医学。该领域还有很多工作要做。话虽如此,我们认为儿科临床医生在不久的将来会越来越频繁地在儿童护理中使用宏基因组技术。