Zhang Xiyue, Ye Jian, Wang Limin, Zhang Liuhai, Wang Liusheng, Jin Hualiang
Department of Respiratory Medicine, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, People's Republic of China.
Department of Respiratory Medicine, Zhejiang Hospital, Hangzhou, People's Republic of China.
Infect Drug Resist. 2024 Aug 24;17:3659-3667. doi: 10.2147/IDR.S475861. eCollection 2024.
Next-generation sequencing of the metagenome (mNGS) is gaining traction as a valuable tool for diagnosing infectious diseases. Compared to mNGS, pathogen detection based on Oxford Nanopore Technology further shortens the detection time. This study seeks to assess the efficacy of Nanopore sequencing in identifying pathogens associated with community-acquired pneumonia (CAP) among elderly individuals in China.
From January 2023 to June 2023, elderly patients with CAP were prospectively recruited from Hangzhou First People's Hospital. A comprehensive set of clinical data was gathered, and bronchoalveolar lavage (BAL) fluid samples were collected. Concurrently, pathogen identification was performed using conventional microbiological diagnostic methods, Illumina sequencing, and Nanopore sequencing, and the diagnostic efficacy of pathogen detection was compared.
The study included a total of 29 patients. The diagnostic positivity rates of traditional microbiological detection, Illumina sequencing, and Nanopore sequencing were 24.1%, 51.7%, and 48.3%, respectively. Their diagnostic specificities were 91.7%, 50%, and 75%, respectively. Compared to traditional microbiological detection, both Nanopore and Illumina sequencing showed significantly increased sensitivity. However, Nanopore sequencing exhibited relatively better consistency with the final clinical comprehensive diagnosis, with a Kappa value of 0.574. This outperformed traditional microbiological detection and Illumina sequencing, which had a Kappa value of 0.296 and 0.402, respectively. In addition, Nanopore sequencing required the shortest turnaround time.
Nanopore sequencing technology demonstrates as a reliable and rapid method for detecting pathogens in elderly patients with CAP.
宏基因组下一代测序（mNGS）作为诊断传染病的一种有价值工具正越来越受到关注。与mNGS相比，基于牛津纳米孔技术的病原体检测进一步缩短了检测时间。本研究旨在评估纳米孔测序在中国老年社区获得性肺炎（CAP）患者中识别病原体的效能。
2023年1月至2023年6月，前瞻性纳入杭州市第一人民医院的老年CAP患者。收集了一套全面的临床数据，并采集支气管肺泡灌洗（BAL）液样本。同时，采用传统微生物诊断方法、Illumina测序和纳米孔测序进行病原体鉴定，并比较病原体检测的诊断效能。
本研究共纳入29例患者。传统微生物检测、Illumina测序和纳米孔测序的诊断阳性率分别为24.1%、51.7%和48.3%。它们的诊断特异性分别为91.7%、50%和75%。与传统微生物检测相比，纳米孔测序和Illumina测序的敏感性均显著提高。然而，纳米孔测序与最终临床综合诊断的一致性相对较好，Kappa值为0.574。这优于传统微生物检测和Illumina测序，它们的Kappa值分别为0.296和0.402。此外，纳米孔测序所需的周转时间最短。
纳米孔测序技术是检测老年CAP患者病原体的一种可靠且快速的方法。
