Zhang Pinjie, Lu Zhonghua, Cao Lijun, Fu Lu, Chen Hu, Sun Yun
The First Department of Critical Care Medicine, the Second Affiliated Hospital of Anhui Medical University, No. 678, Furong Road, Hefei Economic Development Zone, Hefei 230601, Anhui Province, China.
The First Department of Critical Care Medicine, the Second Affiliated Hospital of Anhui Medical University, No. 678, Furong Road, Hefei Economic Development Zone, Hefei 230601, Anhui Province, China.
Dig Liver Dis. 2025 Feb;57(2):401-407. doi: 10.1016/j.dld.2024.07.036. Epub 2024 Aug 17.
This study aimed to evaluate the diagnostic performance of metagenomic next-generation sequencing (mNGS) with pancreatic fluid aspiration for the detection of infected pancreatic necrosis (IPN).
This retrospective observational study included 66 patients with suspected IPN. The participants simultaneously underwent pancreatic fluid aspiration mNGS, and microbial and blood culture. We compared the diagnostic performance of mNGS with that of culture in the detection of pathogens associated with IPN.
Of the 66 patients, 45 (68.2 %) were confirmed to have IPN. Pancreatic fluid aspiration mNGS yielded positive results in 32 of these patients (71.1 %), significantly outperforming microbial culture results (25 patients, 55.6 %; P = 0.039); however, both methods exhibited similar specificity (95.2% vs. 100 %). The results of pancreatic fluid aspiration mNGS and microbial culture matched in 73.3 % (33/45) of patients with IPN. The turnaround time for the mNGS results was significantly shorter than that for the microbial culture method (P < 0.001). In addition, survival analysis demonstrated that a positive mNGS result was not associated with increased mortality (hazard ratio, 0.652; 95 % confidence interval 0.157-2.699, P = 0.555).
Our study highlights the potential of mNGS for diagnosing IPN, with implications for improving patient care by facilitating early and accurate diagnosis, guiding appropriate interventions, and possibly improving patient outcomes.
本研究旨在评估通过胰腺液抽吸进行宏基因组下一代测序（mNGS）对感染性胰腺坏死（IPN）的诊断性能。
这项回顾性观察性研究纳入了66例疑似IPN患者。参与者同时接受了胰腺液抽吸mNGS以及微生物和血液培养。我们比较了mNGS与培养在检测与IPN相关病原体方面的诊断性能。
66例患者中，45例（68.2%）被确诊为IPN。其中32例患者（71.1%）的胰腺液抽吸mNGS结果呈阳性，显著优于微生物培养结果（25例患者，55.6%；P = 0.039）；然而，两种方法的特异性相似（分别为95.2%和100%）。在IPN患者中，胰腺液抽吸mNGS与微生物培养结果的匹配率为73.3%（33/45）。mNGS结果的周转时间明显短于微生物培养方法（P < 0.001）。此外，生存分析表明，mNGS阳性结果与死亡率增加无关（风险比，0.652；95%置信区间0.157 - 2.699，P = 0.555）。
我们的研究突出了mNGS在诊断IPN方面的潜力，通过促进早期准确诊断、指导适当干预以及可能改善患者预后，对改善患者护理具有重要意义。
