采用宏基因组二代测序技术检测疑似感染性胰腺坏死患者胰液抽吸物中的潜在病原体。
Detection of potential pathogen in pancreatic fluid aspiration with metagenomic next-generation sequencing in patients with suspected infected pancreatic necrosis.
作者信息
Hong Donghuang, Wang Peng, Chen Yingjie, Zhang Jingzhu, Jiang Wendi, Ye Bo, Li Gang, Zhou Jing, Mao Wenjian, Tong Zhihui, Li Weiqin, Ke Lu
机构信息
The First School of Clinical Medicine, Southern Medical University, Guangzhou, China; Department of Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, China.
Center of Severe Acute Pancreatitis (CSAP), Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
出版信息
Dig Liver Dis. 2023 Feb;55(2):243-248. doi: 10.1016/j.dld.2022.07.014. Epub 2022 Aug 7.
BACKGROUND
Timely and accurate microbial diagnosis is important in managing patients with infected pancreatic necrosis (IPN).
AIMS
To evaluate the diagnostic performance of Metagenomic next-generation sequencing (mNGS) in patients with suspected IPN.
METHODS
The clinical data of 40 patients with suspected IPN who underwent CT-guided pancreatic fluid aspiration were retrospectively analyzed. Microbial culture and mNGS were simultaneously applied to identify the potential pathogens. The diagnostic performance of the mNGS was assessed by sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
RESULTS
The mNGS report can be obtained significantly earlier than culture methods (42 (36-62 h) vs. 60 (42-124 h), P = 0.032). Across all the study samples, seven species of bacteria and two species of fungi were reported accordingly to the culture results, while 22 species of bacteria and two species of fungi were detected by mNGS. The sensitivity, specificity, NPV, and PPV of mNGS were 88.0%, 100%, 83.33%, and 100%, respectively.
CONCLUSIONS
The diagnostic accuracy of mNGS in patients with suspected IPN is satisfactory. Moreover, mNGS may broaden the range of identifiable infectious pathogens and provide a more timely diagnosis.
背景
及时、准确的微生物诊断对于感染性胰腺坏死（IPN）患者的管理至关重要。
目的
评估宏基因组下一代测序（mNGS）在疑似IPN患者中的诊断性能。
方法
回顾性分析40例接受CT引导下胰腺液体抽吸的疑似IPN患者的临床资料。同时应用微生物培养和mNGS来鉴定潜在病原体。通过敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）评估mNGS的诊断性能。
结果
mNGS报告的获取时间明显早于培养方法（42（36 - 62小时）对60（42 - 124小时），P = 0.032）。在所有研究样本中，根据培养结果报告了7种细菌和2种真菌，而通过mNGS检测到22种细菌和2种真菌。mNGS的敏感性、特异性、NPV和PPV分别为88.0%、100%、83.33%和100%。
结论
mNGS在疑似IPN患者中的诊断准确性令人满意。此外，mNGS可能会扩大可识别的感染性病原体范围，并提供更及时的诊断。
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