Zhu Junfeng, Xia Honghe, Tang Ruqing, Ng Tsz Kin, Yao Fen, Liao Xulong, Zhang Qi, Ke Xixuan, Shi Tingkun, Chen Haoyu
Joint Shantou International Eye Center, Shantou University and the Chinese University of Hong Kong, Shantou, China; and.
Department of Pharmacology, Shantou University Medical College, Shantou, China.
Retina. 2022 May 1;42(5):992-1000. doi: 10.1097/IAE.0000000000003406.
To investigate the utility of metagenomic next-generation sequencing (mNGS) in identifying the pathogens in endophthalmitis.
In this prospective study, 36 cases of endophthalmitis were recruited. All patients received surgical treatment and intraocular drug lavage. The samples of vitreous or aqueous humor were extracted for mNGS and microbiological culture. The diagnostic performance of pathogens was compared between mNGS and culture.
The positive rates of mNGS and culture were 88.89% (32/36) and 27.78% (10/36), respectively. There was a statistically significant difference between mNGS and culture (Chi-square = 27.657; P < 0.01). Staphylococcus epidermidis, Streptococcus pneumoniae, and Klebsiella pneumoniae were the most pathogenic bacteria in traumatic, postoperative, and endogenous endophthalmitis, respectively. The concordance of pathogen identified by mNGS and culture was 70% for culture-positive cases. Antibiotic resistance genes were identified in 9 cases. There was a marginal correlation between the final visual acuity and the microbial sequence read (Spearman correlation coefficient = 0.498; P = 0.05).
Metagenomic next-generation sequencing has a higher positive rate of identifying pathogens in endophthalmitis than in culture. It can also provide information on antibiotic resistance and visual prognosis. However, caution must be taken when interpreting the results of mNGS because they may not be concordant with culture.
探讨宏基因组下一代测序（mNGS）在眼内炎病原体鉴定中的应用价值。
在这项前瞻性研究中，招募了36例眼内炎患者。所有患者均接受手术治疗及眼内药物灌洗。提取玻璃体或房水样本进行mNGS和微生物培养。比较mNGS和培养在病原体诊断方面的表现。
mNGS和培养的阳性率分别为88.89%（32/36）和27.78%（10/36）。mNGS和培养之间存在统计学显著差异（卡方 = 27.657；P < 0.01）。表皮葡萄球菌、肺炎链球菌和肺炎克雷伯菌分别是外伤性、术后和内源性眼内炎中最主要的致病菌。对于培养阳性病例，mNGS和培养鉴定出的病原体一致性为70%。在9例中鉴定出了抗生素耐药基因。最终视力与微生物序列读数之间存在微弱相关性（斯皮尔曼相关系数 = 0.498；P = 0.05）。
宏基因组下一代测序在眼内炎病原体鉴定中的阳性率高于培养。它还可以提供抗生素耐药性和视力预后信息。然而，在解释mNGS结果时必须谨慎，因为其结果可能与培养结果不一致。
