下一代测序技术在血液感染诊断中的表现。
Performance of next-generation sequencing for diagnosis of blood infections by .
机构信息
Department of Emergency, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
出版信息
Front Cell Infect Microbiol. 2023 Dec 1;13:1278482. doi: 10.3389/fcimb.2023.1278482. eCollection 2023.
OBJECTIVE
(Kp) bloodstream infections (BSI) can be a life-threatening opportunistic infection. We aimed to evaluate the diagnostic accuracy of metagenomic next-generation sequencing (mNGS) for Kp BSI.
METHODS
We retrospectively analyzed 72 patients suspected with bloodstream infection and mNGS Kp positive in peripheral blood, who were hospitalized in our hospital from January 2022 to January 2023. Clinical data and laboratory parameters were collected. All patients had blood drawn and other samples for blood mNGS, blood cultures (BC) and other cultures (OC). The accuracy of mNGS results was analyzed according to infection site, clinical indicators, therapeutic effect and routine culture results. The detection of pathogenic microorganisms by blood mNGS and routine culture was compared.
RESULTS
Among 72 infection patients, 29 cases (40.28%) were BC positive, 43 cases (59.72%) were other culture (OC) positive, 16 cases (22.22%) were both BC and OC positive, 56 cases were positive for both mNGS and routine culture. Among the 56 double-positive cases, mNGS and conventional cultures were completely consistent in 27 cases, partially consistent in 15 cases, and completely inconsistent in 14 cases. Using the clinical diagnosis as the reference standard, There were 51 cases consistent with the results of mNGS with Kp BSI, the clinical consistency was 70.83% (51/72). The coincidence rate of mNGS and clinical diagnosis was higher than that of BC (54.17%, 39/72), indicating a statistically significant difference between the two methods (<0.01).
CONCLUSIONS
Current evidence indicates that mNGS exhibits excellent accuracy for the diagnosis of Kp BSI. Although it cannot replace blood culture detection technology, it can be used as a supplement to provide stronger diagnostic capabilities for BSI and optimize treatment.
目的
（Kp）血流感染（BSI）可能是一种危及生命的机会性感染。我们旨在评估宏基因组下一代测序（mNGS）对 Kp BSI 的诊断准确性。
方法
我们回顾性分析了 2022 年 1 月至 2023 年 1 月我院收治的 72 例疑似血流感染且外周血 mNGS Kp 阳性的患者。收集临床资料和实验室参数。所有患者均进行血样采集和其他样本的血 mNGS、血培养（BC）和其他培养（OC）。根据感染部位、临床指标、治疗效果和常规培养结果分析 mNGS 结果的准确性。比较血 mNGS 和常规培养对病原体微生物的检测。
结果
72 例感染患者中，BC 阳性 29 例（40.28%），OC 阳性 43 例（59.72%），BC 和 OC 均阳性 16 例（22.22%），mNGS 和常规培养均阳性 56 例。在 56 例双阳性病例中，mNGS 和常规培养完全一致 27 例，部分一致 15 例，完全不一致 14 例。以临床诊断为参考标准，有 51 例与 mNGS 结果一致的 Kp BSI，临床符合率为 70.83%（51/72）。mNGS 与临床诊断的吻合率高于 BC（54.17%，39/72），两种方法差异有统计学意义（<0.01）。
结论
目前的证据表明，mNGS 对 Kp BSI 的诊断具有出色的准确性。虽然它不能替代血液培养检测技术，但可以作为补充，为 BSI 提供更强的诊断能力并优化治疗。
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