Chen Xianqiu, Cheng Kebin, Sun Xiaoli, Zhang Yuan, Cao Zu, Li Jianxiong, Bai Jiuwu, Lu Haiwen, Gu Shuyi, Zhang Li, Xu Jinfu, Jiang Ping, Liang Shuo
Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China.
Ann Transl Med. 2021 Apr;9(8):702. doi: 10.21037/atm-21-1322.
The major causes of pulmonary infections are various microorganisms. This study aimed to compare the positive rates of pathogenic microorganism DNA/RNA high-throughput genetic sequencing (PMseq), which is an emerging technique, with traditional methods for pulmonary disease detection, and to investigate the differences in different sample types.
Bronchoalveolar lavage fluid (BALF) and venous blood samples from 104 patients were collected for detection.
The positive rates of PMseq in BALF and venous blood were both significantly higher than those of traditional methods in the same sample (P<0.001). For BALF, the detection sensitivities were 96.9% for non-febrile patients and 100% for febrile patients. For venous blood, the detection sensitivities were 50.0% for non-febrile patients and 81.3% for febrile patients. There was no statistical difference in the sensitivity of venous blood samples with or without fever (P=0.075). For patients without fever, the sensitivity of BALF was much higher than venous blood samples (P<0.001). In patients with fever, there were no significant differences between different samples.
This study showed that PMseq has a higher positive rate for the detection of pulmonary diseases. For patients without fever, it is recommended to use BALF instead of venous blood samples because of the higher sensitivity. However, for patients with fever, venous blood samples can be used when bronchoalveolar lavage is inconvenient.
肺部感染的主要病因是多种微生物。本研究旨在比较新兴技术病原微生物DNA/RNA高通量基因测序(PMseq)与传统肺部疾病检测方法的阳性率,并研究不同样本类型之间的差异。
收集104例患者的支气管肺泡灌洗液(BALF)和静脉血样本进行检测。
BALF和静脉血中PMseq的阳性率均显著高于同一样本的传统方法(P<0.001)。对于BALF,非发热患者的检测灵敏度为96.9%,发热患者为100%。对于静脉血,非发热患者的检测灵敏度为50.0%,发热患者为81.3%。发热和未发热的静脉血样本灵敏度无统计学差异(P=0.075)。对于未发热患者,BALF的灵敏度远高于静脉血样本(P<0.001)。在发热患者中,不同样本之间无显著差异。
本研究表明,PMseq对肺部疾病的检测阳性率更高。对于未发热患者,由于灵敏度更高,建议使用BALF而非静脉血样本。然而,对于发热患者,当支气管肺泡灌洗不方便时,可以使用静脉血样本。