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宏基因组测序在肺部感染性疾病诊断中的优势和挑战。

Advantages and challenges of metagenomic sequencing for the diagnosis of pulmonary infectious diseases.

机构信息

Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Institute of Respiratory Medicine, Tongji University School of Medicine, Shanghai, China.

出版信息

Clin Respir J. 2022 Oct;16(10):646-656. doi: 10.1111/crj.13538. Epub 2022 Sep 6.

Abstract

OBJECTIVE

We aim to familiarize the application status of metagenomic sequencing in diagnosing pulmonary infections, to compare metagenomic sequencing with traditional diagnostic methods, to conclude the advantages and limitations of metagenomic sequencing, and to provide some advice for clinical practice and some inspiration for associated researches.

DATA SOURCES

The data were obtained from peer-reviewed literature, white papers, and meeting reports.

RESULTS

This review focused on the applications of untargeted metagenomic sequencing in lungs infected by bacteria, viruses, fungi, chlamydia pneumoniae, Mycoplasma pneumoniae, parasites, and other pathogens. Compared with conventional diagnostic methods, metagenomic sequencing is better in detecting novel, rare, and unexpected pathogens and being applied in co-infections. Meanwhile, it can also provide more comprehensive information about pathogens. However, metagenomic sequencing still has limitations. Also, the situations that should be applied in and how the results should be interpreted are discussed in this review.

CONCLUSION

Metagenomic sequencing improves efficiency to identify pathogens compared with traditional diagnostic methods and can be applied in clinical diagnosis. However, the technology of metagenomic sequencing still needs to be improved. Also, clinicians should learn more about when to use metagenomic sequencing and how to interpret its results.

摘要

目的

使人们熟悉宏基因组测序在肺部感染诊断中的应用现状,比较宏基因组测序与传统诊断方法的区别,总结宏基因组测序的优势和局限性,并为临床实践提供一些建议和为相关研究提供一些启示。

资料来源

数据来源于同行评议文献、白皮书和会议报告。

结果

本综述重点关注了无靶向宏基因组测序在细菌、病毒、真菌、肺炎衣原体、肺炎支原体、寄生虫等病原体感染肺部的应用。与传统诊断方法相比,宏基因组测序在检测新型、罕见和意外病原体以及用于混合感染方面具有优势。同时,它还可以提供有关病原体的更全面的信息。然而,宏基因组测序仍然存在局限性。本综述还讨论了应该在哪些情况下应用以及如何解释其结果。

结论

与传统诊断方法相比,宏基因组测序可提高识别病原体的效率,可应用于临床诊断。然而,宏基因组测序技术仍有待改进。此外,临床医生应更多地了解何时使用宏基因组测序以及如何解释其结果。

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