Zhang Heng, Lu Ming, Guo Chaomin, Wang Lifeng, Ye Kun, Zhao Qiang, Yang Jiyong, Yang Liuyang, Li Tanshi
Department of Emergency, The First Medical Center, Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing, 100853, China.
Laboratory Medicine Department, Tangshan Nanhu Hospital, Hebei, 063000, China.
Heliyon. 2024 Jul 26;10(15):e35287. doi: 10.1016/j.heliyon.2024.e35287. eCollection 2024 Aug 15.
The real-world clinical impact of mNGS on BALF in the respiratory intensive care unit (RICU) is not yet fully understood.
We investigated the clinical impact of mNGS on BALF samples obtained from 92 patients admitted to the RICU over a 2-year period. We utilized both mNGS and culture methods to evaluate the effectiveness of mNGS in diagnosing pulmonary infections. The clinical impact of mNGS were evaluated by the clinician committees.
Among the 92 diagnosed patients, 78 cases (84.7 %) were determined to have infectious diseases caused by pathogenic microorganisms, and the bacterial infections constituted the most prevalent diagnostic category. For mixed infection, the most common type was the and cytomegalovirus co-infection. The mNGS results had a positive impact on the clinical management of 43 cases (46.7 %). Moreover, 19 cases (44.2 %) of positive clinical impacts were solely based on new diagnoses made possible by mNGS results. These new diagnoses were particularly helpful for identifying rare pathogens, which could not be detected by conventional diagnostic methods.
The BALF mNGS has a positive real-world impact in RICU. Clinician committee play a critical role in ensuring the appropriate use of mNGS.
宏基因组二代测序（mNGS）对呼吸重症监护病房（RICU）中支气管肺泡灌洗（BALF）样本的实际临床影响尚未完全明确。
我们调查了mNGS对2年内入住RICU的92例患者的BALF样本的临床影响。我们同时采用mNGS和培养方法来评估mNGS在诊断肺部感染方面的有效性。mNGS的临床影响由临床医生委员会进行评估。
在92例确诊患者中，78例（84.7%）被确定为由致病微生物引起的感染性疾病，其中细菌感染是最常见的诊断类型。对于混合感染，最常见的类型是[此处原文缺失信息]与巨细胞病毒共感染。mNGS结果对43例（46.7%）患者的临床管理产生了积极影响。此外，19例（44.2%）产生积极临床影响的情况完全基于mNGS结果做出的新诊断。这些新诊断对于识别常规诊断方法无法检测到的罕见病原体特别有帮助。
BALF的mNGS在RICU中具有积极的实际影响。临床医生委员会在确保mNGS的合理使用方面发挥着关键作用。
