Huang Po-Hsiu, Huang Yao-Ting, Lee Po-Hsin, Tseng Chien-Hao, Liu Po-Yu, Liu Chia-Wei
Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Department of Computer Science and Information Engineering, National Chung Cheng University, Chia-Yi, Taiwan.
Infect Drug Resist. 2023 Jan 20;16:355-362. doi: 10.2147/IDR.S396254. eCollection 2023.
Coinfection in COVID-19 patients is associated with worsening outcome. Among patients with COVID-19, , a common cause of pneumonia, has been reported as a co-occurring respiratory infection. A nonspecific clinical presentation, however, makes an early diagnosis difficult. Bronchoalveolar lavage fluid was collected from a patient suffering from COVID-19 and presenting with pneumonia and sent for metagenomic analysis. Differential abundance analysis was carried out by comparing each taxon reads per million between the bronchoalveolar lavage fluid sample and the negative control. Two replicates of metagenomic sequencing were conducted on bronchoalveolar lavage fluid samples. Within each replicated sequencing, one negative control was sequenced for comparison of taxon abundance in the BALF sample. In both replicates, was the only taxon with significantly higher abundance when compared with the negative control. PCR of the bronchoalveolar further confirmed the presence of . Several studies have estimated that the incidence of Legionnaires' disease co-infection in patients with COVID-19 infection is approximately 0% to 1.5%. There are some common characteristics of COVID-19 and co-infection with Legionnaires' disease, making it difficult to diagnose bacterial infection early. The diagnosis of these cases is important due to the different treatments used. Current diagnostic tests for Legionnaires' disease include conventional culture, urinary antigen for serogroup 1, polymerase chain reaction, direct fluorescent antibody stain, and paired serology. The current study demonstrated that metagenomics is a promising approach that facilitated the diagnosis of Legionnaires' disease.
新冠病毒感染患者的合并感染与病情恶化相关。在新冠病毒感染患者中，已报告一种常见的肺炎病因——军团菌病，为同时发生的呼吸道感染。然而，非特异性临床表现使得早期诊断困难。从一名患有新冠病毒感染且伴有肺炎的患者采集支气管肺泡灌洗液，并送去进行宏基因组分析。通过比较支气管肺泡灌洗液样本与阴性对照中每百万的各分类群读数，进行差异丰度分析。对支气管肺泡灌洗液样本进行了两次宏基因组测序重复实验。在每次重复测序中，对一个阴性对照进行测序，以比较支气管肺泡灌洗液样本中的分类群丰度。在两次重复实验中，与阴性对照相比，军团菌是唯一丰度显著更高的分类群。支气管肺泡灌洗液的聚合酶链反应进一步证实了军团菌的存在。几项研究估计，新冠病毒感染患者中军团菌病合并感染的发生率约为0%至1.5%。新冠病毒感染与军团菌病合并感染有一些共同特征，使得早期诊断细菌感染困难。由于治疗方法不同，这些病例的诊断很重要。目前针对军团菌病的诊断测试包括传统培养、1型血清群的尿抗原检测、聚合酶链反应、直接荧光抗体染色和双份血清学检测。当前研究表明，宏基因组学是一种有助于军团菌病诊断的有前景的方法。
