肺炎患者血液及支气管肺泡灌洗液的宏基因组下一代测序
Blood and Bronchoalveolar Lavage Fluid Metagenomic Next-Generation Sequencing in Pneumonia.
作者信息
Chen Xu, Ding Shuizi, Lei Cheng, Qin Jieli, Guo Ting, Yang Danhui, Yang Min, Qing Jie, He Wenlong, Song Min, Zhang Yan, Zeng Huihui, Qin Qingwu, Yang Lizhen, Long Yingjiao, Chen Yan, Ma Bingyin, Ouyang Ruoyun, Chen Ping, Luo Hong
机构信息
Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, China.
出版信息
Can J Infect Dis Med Microbiol. 2020 Aug 12;2020:6839103. doi: 10.1155/2020/6839103. eCollection 2020.
BACKGROUND
Metagenomic next-generation sequencing (mNGS) has made a revolution in the mode of pathogen identification. We decided to explore the diagnostic value of blood and bronchoalveolar lavage fluid (BALF) as mNGS samples in pneumonia.
METHODS
We retrospectively reviewed 467 mNGS results and assessed the diagnostic performance of paired blood and BALF mNGS in 39 patients with pneumonia.
RESULTS
For bacteria and fungi, 16 patients had culture-confirmed pathogen diagnosis, while 13 patients were culture-negative. BALF mNGS was more sensitive than blood mNGS (81.3% vs. 25.0%, =0.003), and the specificity in BALF and blood mNGS was not statistically significant different (76.9% vs. 84.6%, =0.317). For 10 patients without culture test, treatments were changed in 2 patients. For viruses, Epstein-Barr virus was positive in blood mNGS in 9 patients. Human adenovirus was detected in both BALF and blood mNGS in 3 patients.
CONCLUSION
Our study suggests that BALF mNGS is more sensitive than blood mNGS in detecting bacteria and fungi, but blood also has advantages to identify the pathogens of pneumonia, especially for some viruses.
背景
宏基因组下一代测序（mNGS）在病原体鉴定模式方面引发了一场革命。我们决定探讨血液和支气管肺泡灌洗液（BALF）作为mNGS样本在肺炎诊断中的价值。
方法
我们回顾性分析了467份mNGS结果，并评估了39例肺炎患者配对的血液和BALF mNGS的诊断性能。
结果
对于细菌和真菌，16例患者经培养确诊病原体，13例患者培养结果为阴性。BALF mNGS比血液mNGS更敏感（81.3%对25.0%，P=0.003），BALF和血液mNGS的特异性无统计学显著差异（76.9%对84.6%，P=0.317）。对于10例未进行培养检测的患者，2例患者的治疗方案发生了改变。对于病毒，9例患者血液mNGS中EB病毒呈阳性。3例患者的BALF和血液mNGS中均检测到人类腺病毒。
结论
我们的研究表明，BALF mNGS在检测细菌和真菌方面比血液mNGS更敏感，但血液在鉴定肺炎病原体方面也有优势，尤其是对于某些病毒。
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