Zhang Rong, Zhuang Yan, Xiao Zheng-Hui, Li Cai-Yun, Zhang Fan, Huang Wei-Qing, Zhang Min, Peng Xiao-Ming, Liu Chao
Department of Neonatology, Hunan Children's Hospital, Changsha, China.
Department of Emergency, Hunan Children's Hospital, Changsha, China.
Front Microbiol. 2022 Mar 24;13:855988. doi: 10.3389/fmicb.2022.855988. eCollection 2022.
Microbial infections cause significant morbidity and mortality in neonates. Metagenomic next-generation sequencing is a hypothesis-free and culture-free test that enables broad identification of pathogens and antimicrobial resistance genes directly from clinical samples within 24 h. In this study, we used mNGS for etiological diagnosis and monitoring the efficacy of antibiotic treatment in a cohort of neonatal patients with severe infections. The median age was 19.5 (3-52) days, median gestational age was 37.96 (31-40) weeks, and the median birth weight was 3,261 (1,300-4,300) g. The types of infectious diseases included pneumonia, sepsis, and meningitis. mNGS reported microbial findings in all cases, which led to changes in antibiotic treatment. These included cases of , , and . Eight of ten infants recovered after antibiotic adjustment and showed normal development during follow-up. On the other hand, neurological retardation was seen in two infants with meningitis. mNGS enabled etiological diagnosis and guided antibiotic therapy when all conventional methods failed to discover the culprit. It has the potential to cut down the overall cost and burden of disease management in neonatal infections.
微生物感染在新生儿中会导致严重的发病率和死亡率。宏基因组下一代测序是一种无需假设且无需培养的检测方法，能够在24小时内直接从临床样本中广泛鉴定病原体和抗菌耐药基因。在本研究中，我们使用宏基因组下一代测序对一组患有严重感染的新生儿患者进行病因诊断并监测抗生素治疗的疗效。中位年龄为19.5（3 - 52）天，中位胎龄为37.96（31 - 40）周，中位出生体重为3261（1300 - 4300）克。传染病类型包括肺炎、败血症和脑膜炎。宏基因组下一代测序在所有病例中均报告了微生物检测结果，这导致了抗生素治疗的改变。这些病例包括 、 和 。十名婴儿中有八名在抗生素调整后康复，并且在随访期间发育正常。另一方面，两名患有脑膜炎的婴儿出现了神经发育迟缓。当所有传统方法均未能找出病原体时，宏基因组下一代测序能够进行病因诊断并指导抗生素治疗。它有可能降低新生儿感染疾病管理的总体成本和负担。
