Hao Xinlei, Wang Ming, Yuan Man, Zhang Rui, Jin Wei, Yang Anhuai
Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan 430060, China.
Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China; and.
Retina. 2023 Apr 1;43(4):606-615. doi: 10.1097/IAE.0000000000003719. Epub 2022 Dec 27.
Nanopore targeted sequencing showed a higher positivity rate and a shorter turnaround time than did traditional culture in identifying pathogens in the intraocular fluid samples of patients with endogenous endophthalmitis.
To evaluate the feasibility of clinical application of nanopore targeted sequencing (NTS) for the identification of pathogens in patients with endogenous endophthalmitis, especially those with fungus-associated endophthalmitis.
In this retrospective study, medical records and etiological results of 27 patients (34 eyes) with endogenous endophthalmitis were reviewed. The intraocular fluid samples were examined using both NTS and microbial culture. The results included the differences in detection time, positivity rate of pathogen detection, and positivity rate of fungus identification between two methods.
NTS and microbial culture enabled the detection of etiologic agents in 89.28% and 35.71% of the samples, respectively. The difference of positivity rate between these methods was statistically significant ( P < 0.001). NTS also showed high sensitivity in both culture-positive and culture-negative samples (100% and 83.33%, respectively). Regarding culture-positive samples, the NTS results displayed a strong match with culture results. NTS showed a significantly higher positivity rate for fungal infection than did microbial culture (46.43% vs. 7.14%, P = 0.002). The average detection time of NTS was 1.11 ± 0.31 days, which was shorter than that of microbial culture (2.50 ± 0.58 days, Z = -4.686, P < 0.001). NTS technology facilitated an informed switch of intravitreal antimicrobial agents in 13 eyes.
NTS, as a sensitive, specific, and timely complementary method, can be used along with traditional methods for the identification of pathogenic microorganisms in the intraocular fluid of patients with endogenous endophthalmitis.
在内源性眼内炎患者的眼内液样本中，与传统培养方法相比，纳米孔靶向测序在鉴定病原体方面显示出更高的阳性率和更短的周转时间。
评估纳米孔靶向测序（NTS）在鉴定内源性眼内炎患者病原体，尤其是真菌相关性眼内炎患者病原体方面临床应用的可行性。
在这项回顾性研究中，对27例（34只眼）内源性眼内炎患者的病历和病因学结果进行了回顾。使用NTS和微生物培养对眼内液样本进行检测。结果包括两种方法在检测时间、病原体检测阳性率以及真菌鉴定阳性率方面的差异。
NTS和微生物培养分别在89.28%和35.71%的样本中检测到病原体。这些方法之间阳性率的差异具有统计学意义（P < 0.001）。NTS在培养阳性和培养阴性样本中均显示出高敏感性（分别为100%和83.33%）。对于培养阳性样本，NTS结果与培养结果高度匹配。NTS显示真菌感染的阳性率显著高于微生物培养（46.43%对7.14%，P = 0.002）。NTS的平均检测时间为1.11±0.31天，短于微生物培养（2.50±0.58天，Z = -4.686，P < 0.001）。NTS技术促使13只眼中的玻璃体内抗菌药物进行了明智的更换。
NTS作为一种敏感、特异且及时的补充方法，可与传统方法一起用于鉴定内源性眼内炎患者眼内液中的致病微生物。
