Liang Yanxu, Feng Qingguo, Wei Kai, Hou Xiaoming, Song Xiaotao, Li Yuantao
Department of Critical Care Medicine, The Fifth Central Hospital of Tianjin, Tianjin, 300450, China.
Department of Critical Care Medicine, The Fifth Central Hospital of Tianjin, Tianjin, 300450, China.
Mol Cell Probes. 2023 Apr;68:101898. doi: 10.1016/j.mcp.2023.101898. Epub 2023 Mar 16.
Due to the limitations of traditional microbiological detection techniques in evaluating complicated infections in ICU patients, it is necessary to explore novel and effective methods to improve the clinical detection of ICU patients' infections.
This study aimed to evaluate the efficiency and specificity of mNGS in screening pathogens in the blood, deep phlegm, urine, and other sample types of ICU patients exploring an effective method for infection detection.
A total of 56 ICU patients with 131 samples were included in this study. The sample types included blood, deep phlegm, urine, drainage, anal swabs, and other types. Samples were analyzed by both conventional detection method and mNGS tests. The diagnosis efficiency and consistency of the two methods were compared. The distribution of the identified pathogens was analyzed. Moreover, the clinical features of patients with mNGS-positive or mNGS-negative results were compared.
The positive rate of mNGS was 81.7% (107/131) including 3.1% (4/131) weakly positive, while the positive rate of traditional detection was only 30.5%, including 29 strong positive results and 11 weak positive results. Additionally, there were 41 patients chose to adjust anti-infection strategies according to the results of mNGS, which significantly saved treatment costs. The mNGS-positive patients showed a shorter ICU hospitalization and higher intention to adjust anti-infection strategies than the mNGS-negative patients.
mNGS is of great potential for the pathogen detection of ICU patients, and has a higher detection rate than traditional detection methods. Further clinical application investigations can be carried out to expand the application of mNGS.
由于传统微生物检测技术在评估重症监护病房（ICU）患者复杂感染方面存在局限性，有必要探索新颖有效的方法来改善ICU患者感染的临床检测。
本研究旨在评估宏基因组测序（mNGS）在筛查ICU患者血液、深部痰液、尿液及其他样本类型中病原体的效率和特异性，探索一种有效的感染检测方法。
本研究共纳入56例ICU患者的131份样本。样本类型包括血液、深部痰液、尿液、引流液、肛拭子等。样本分别采用传统检测方法和mNGS检测。比较两种方法的诊断效率和一致性。分析鉴定出的病原体分布情况。此外，比较mNGS阳性或阴性结果患者的临床特征。
mNGS阳性率为81.7%（107/131），其中弱阳性率为3.1%（4/131），而传统检测阳性率仅为30.5%，包括29个强阳性结果和11个弱阳性结果。此外，有41例患者根据mNGS结果选择调整抗感染策略，显著节省了治疗费用。mNGS阳性患者在ICU的住院时间比mNGS阴性患者短，且调整抗感染策略的意愿更高。
mNGS在ICU患者病原体检测方面具有巨大潜力，检测率高于传统检测方法。可开展进一步的临床应用研究以扩大mNGS的应用。
