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宏基因组下一代测序用于检测肺部感染患者的致病微生物。

Metagenomic next-generation sequencing for the detection of pathogenic microorganisms in patients with pulmonary infection.

作者信息

Wei Peng, Wu Lijuan, Li Yu, Shi Jian'gang, Luo Yifeng, Wu Wenbin, Feng Jiemei

机构信息

Department of Pulmonary and Critical Care Medicine, The Eighth Affiliated Hospital of Guangxi Medical University & Guigang City People's Hospital Guigang 537100, Guangxi Zhuang Autonomous Region, China.

Department of Ultrasound, The Eighth Affiliated Hospital of Guangxi Medical University & Guigang City People's Hospital Guigang 537100, Guangxi Zhuang Autonomous Region, China.

出版信息

Am J Transl Res. 2022 Sep 15;14(9):6382-6388. eCollection 2022.

Abstract

OBJECTIVE

To explore the clinical value of metagenomic next-generation sequencing (mNGS) in diagnosing pulmonary infectious diseases.

METHODS

A retrospective analysis was performed on 82 patients with pulmonary infection who were admitted to the Eighth Affiliated Hospital of Guangxi Medical University & Guigang City People's Hospital from January 2020 to December 2021. The pathogens were detected by mNGS and conventional methods (culture and PCR). Then, the type and number of detected pathogens, as well as the specificity and sensitivity, were compared between the two methods. In addition, the positive rates of bacteria, fungi, tubercle bacillus, and mixed infection in bronchoalveolar lavage fluid, sputum, pleural effusion, and blood detected by mNGS, and the advantage in required test time were evaluated.

RESULTS

More types and numbers of pathogens were detected by mNGS with a higher sensitivity but a lower specificity, as compared to the conventional detection methods (all P<0.05). The positive rates and integrity rates of bacteria, fungi, and tubercle bacillus detected by mNGS were higher than those by conventional methods (all P<0.05). Moreover, there was no difference in the overall sensitivity of mNGS among different sample types, but the sensitivities of mNGS in bronchoalveolar lavage fluid and sputum samples were significantly higher than those of conventional methods (both P<0.05). The average test time for mNGS was shorter than that of conventional methods.

CONCLUSION

mNGS can detect more types and numbers of pathogenic microorganisms, improve the detection sensitivity, and reduce the detection time in patients with pulmonary infection.

摘要

目的

探讨宏基因组下一代测序(mNGS)在诊断肺部感染性疾病中的临床价值。

方法

对2020年1月至2021年12月在广西医科大学第八附属医院&贵港市人民医院住院的82例肺部感染患者进行回顾性分析。采用mNGS和传统方法(培养及PCR)检测病原体。然后,比较两种方法检测到的病原体类型和数量,以及特异性和敏感性。此外,评估mNGS检测支气管肺泡灌洗液、痰液、胸腔积液及血液中细菌、真菌、结核杆菌及混合感染的阳性率,以及在所需检测时间方面的优势。

结果

与传统检测方法相比,mNGS检测到的病原体类型和数量更多,敏感性更高,但特异性更低(均P<0.05)。mNGS检测细菌、真菌及结核杆菌的阳性率和完整率均高于传统方法(均P<0.05)。此外,不同样本类型中mNGS的总体敏感性无差异,但mNGS在支气管肺泡灌洗液和痰液样本中的敏感性显著高于传统方法(均P<0.05)。mNGS的平均检测时间短于传统方法。

结论

mNGS能检测到更多类型和数量的致病微生物,提高肺部感染患者的检测敏感性,缩短检测时间。

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