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基于宏基因组下一代测序技术的支气管扩张症患者临床特征与微生物组关联研究。

Association between Clinical Characteristics and Microbiota in Bronchiectasis Patients Based on Metagenomic Next-Generation Sequencing Technology.

机构信息

1The Intensive Care of Unit, The First Hospital of Jiaxing (The Affiliated Hospital of Jiaxing University), Jiaxing, China.

2Department of Respiratory, The First Hospital of Jiaxing (The Affiliated Hospital of Jiaxing University), Jiaxing, China.

出版信息

Pol J Microbiol. 2024 Mar 4;73(1):59-68. doi: 10.33073/pjm-2024-007. eCollection 2024 Mar 1.

Abstract

This study aimed to investigate the disparities between metagenomic next-generation sequencing (mNGS) and conventional culture results in patients with bronchiectasis. Additionally, we sought to investigate the correlation between the clinical characteristics of patients and their microbiome profiles. The overarching goal was to enhance the effective management and treatment of bronchiectasis patients, providing a theoretical foundation for healthcare professionals. A retrospective survey was conducted on 67 bronchiectasis patients admitted to The First Hospital of Jiaxing from October 2019 to March 2023. Clinical baseline information, inflammatory indicators, and pathogen detection reports, including mNGS, conventional blood culture, bronchoalveolar lavage fluid (BALF) culture, and sputum culture results, were collected. By comparing the results of mNGS and conventional culture, the differences in pathogen detection rate and pathogen types were explored, and the diagnostic performance of mNGS compared to conventional culture was evaluated. Based on the various pathogens detected by mNGS, the association between clinical characteristics of bronchiectasis patients and mNGS microbiota results was analyzed. The number and types of pathogens detected by mNGS were significantly larger than those detected by conventional culture. The diagnostic efficacy of mNGS was significantly superior to conventional culture for all types of pathogens, particularly in viral detection ( < 0.01). Regarding pathogen detection rate, the bacteria with the highest detection rate were (17/58) and (11/58); the fungus with the highest detection rate was (10/21), and the virus with the highest detection rate was human herpes virus 4 (4/11). Differences were observed between the positive and negative groups for in terms of common scoring systems for bronchiectasis and whether the main symptom of bronchiectasis manifested as thick sputum ( < 0.05). Significant distinctions were also noted between the positive and negative groups for regarding Reiff score, neutrophil percentage, bronchiectasis etiology, and alterations in treatment plans following mNGS results reporting ( < 0.05). Notably, 70% of patients with positive infection opted to change their treatment plans. The correlation study between clinical characteristics of bronchiectasis patients and mNGS microbiological results revealed that bacteria, such as , and fungi, such as , were associated with specific clinical features of patients. This underscored the significance of mNGS in guiding personalized treatment approaches. mNGS could identify multiple pathogens in different types of bronchiectasis samples and was a rapid and effective diagnostic tool for pathogen identification. Its use was recommended for diagnosing the causes of infections in bronchiectasis patients.

摘要

这项研究旨在探讨支气管扩张症患者中宏基因组下一代测序(mNGS)与传统培养结果之间的差异。此外,我们还研究了患者的临床特征与微生物组谱之间的相关性。总体目标是提高支气管扩张症患者的有效管理和治疗水平,为医疗保健专业人员提供理论基础。对 2019 年 10 月至 2023 年 3 月在嘉兴市第一医院就诊的 67 例支气管扩张症患者进行了回顾性调查。收集了临床基线信息、炎症指标和病原体检测报告,包括 mNGS、常规血培养、支气管肺泡灌洗液(BALF)培养和痰培养结果。通过比较 mNGS 和传统培养的结果,探讨了病原体检测率和病原体类型的差异,并评估了 mNGS 与传统培养的诊断性能。基于 mNGS 检测到的各种病原体,分析了支气管扩张症患者的临床特征与 mNGS 微生物组结果之间的关联。mNGS 检测到的病原体数量和类型明显多于传统培养。mNGS 的诊断效果明显优于传统培养,对所有类型的病原体,尤其是病毒检测( < 0.01)。关于病原体检测率,细菌中检测率最高的是 (17/58)和 (11/58);真菌中检测率最高的是 (10/21),病毒中检测率最高的是人疱疹病毒 4(4/11)。在支气管扩张症的常见评分系统和支气管扩张症的主要症状是否为浓痰方面, 阳性和阴性组之间存在差异( < 0.05)。在 Reiff 评分、中性粒细胞百分比、支气管扩张症病因以及根据 mNGS 结果报告改变治疗方案方面, 阳性和阴性组之间也存在显著差异( < 0.05)。值得注意的是,70% 感染 的患者选择改变治疗方案。支气管扩张症患者的临床特征与 mNGS 微生物学结果的相关性研究表明, 等细菌和 等真菌与患者的特定临床特征相关。这突显了 mNGS 在指导个性化治疗方法方面的重要性。mNGS 可以在不同类型的支气管扩张症样本中识别多种病原体,是一种快速有效的病原体诊断工具。建议将其用于诊断支气管扩张症患者感染的病因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be94/10911701/8a13752cf0f6/j_pjm-2024-007_fig_001.jpg

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