宏基因组下一代测序辅助肺炎诊断:病例系列及文献复习。

Metagenomic next-generation sequencing assists in the diagnosis of pneumonia: Case series and literature review.

机构信息

Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Gene Hospital of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Front Public Health. 2022 Nov 4;10:971511. doi: 10.3389/fpubh.2022.971511. eCollection 2022.

Abstract

BACKGROUND

Pulmonary cryptococcosis (PC) was once thought to occur only in patients with immune deficiencies, such as tested positive for the Human Immunodeficiency Virus (HIV). However, in recent years, it has been discovered that more than half of the patients with PC in our nation are individuals with normal immune function. As more and more PC cases are recorded, our diagnosis and treatment approaches, as well as our understanding of PC, are gradually improving. In reality, most PC patients still have a high incidence of misdiagnosis on their initial visit. It is primarily linked to the diverse clinical manifestations, atypical imaging findings, and inaccurate diagnostic approaches.

METHODS

The research was conducted from 2019 to 2020. We performed traditional microbiological testing and mNGS on sample from patients with fever of Pulmonary nodules or lung infections. Furthermore, we collected patients' baseline information, clinical features, laboratory and imaging examination results, diagnosis, treatment and outcome. In the end, we confirmed three cases of PC using biopsy and mNGS.

CONCLUSION

Our data demonstrates that mNGS can be utilized as an auxiliary method for PC diagnosis. Early mNGS aids in the identification of pathogens, enabling early diagnosis and treatment, as well as a reduction in the rate of misdiagnosis and illness progression.

摘要

背景

肺隐球菌病(PC)曾被认为仅发生于免疫缺陷患者,如人类免疫缺陷病毒(HIV)阳性患者。然而,近年来,我国超过一半的 PC 患者为免疫功能正常者。随着越来越多的 PC 病例被记录,我们对 PC 的诊断和治疗方法以及认识也在逐渐提高。实际上,大多数 PC 患者在初诊时仍存在较高的误诊率,主要与临床表现多样、影像学表现不典型、诊断方法不准确有关。

方法

本研究于 2019 年至 2020 年进行。我们对发热伴肺部结节或肺部感染患者的样本进行了传统微生物学检测和 mNGS。此外,我们收集了患者的基线信息、临床特征、实验室和影像学检查结果、诊断、治疗和转归。最终,我们通过活检和 mNGS 确诊了 3 例 PC。

结论

我们的数据表明,mNGS 可作为 PC 诊断的辅助方法。早期 mNGS 有助于识别病原体,从而实现早期诊断和治疗,降低误诊率和疾病进展率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7380/9672815/227fe1f8eda1/fpubh-10-971511-g0001.jpg

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