多部位 mNGS 检测在重症监护病房脓毒症患者中的临床应用价值。
The clinical application value of multi-site mNGS detection of patients with sepsis in intensive care units.
机构信息
The Fourth Department of Intensive Care Medicine, Meizhou People's Hospital, Meizhou, Guangdong, 514031, China.
The First Department of Intensive Care Medicine, Meizhou People's Hospital, Meizhou People's Hospital, Meizhou, Guangdong, 514031, China.
出版信息
BMC Infect Dis. 2024 Sep 4;24(1):920. doi: 10.1186/s12879-024-09822-y.
BACKGROUND
Sepsis remains a leading cause of mortality in intensive care units, and rapid and accurate pathogen detection is crucial for effective treatment. This study evaluated the clinical application of multi-site metagenomic next-generation sequencing (mNGS) for the diagnosis of sepsis, comparing its performance against conventional methods.
METHODS
A retrospective analysis was conducted on 69 patients with sepsis consecutively admitted to the Department of Intensive Care Medicine, Meizhou People's Hospital. Samples of peripheral blood and infection sites were collected for mNGS and conventional method tests to compare the positive rate of mNGS and traditional pathogen detection methods and the distribution of pathogens. The methods used in this study included a comprehensive analysis of pathogen consistency between peripheral blood and infection site samples. Additionally, the correlation between the pathogens detected and clinical outcomes was investigated.
RESULTS
Of the patients with sepsis, 57.97% experienced dyspnea, and 65.2% had underlying diseases, with hypertension being the most common. mNGS demonstrated a significantly higher pathogen detection rate (88%) compared to the conventional method tests (26%). The pathogen consistency rate was 60% between plasma and bronchoalveolar lavage fluid samples, and that of plasma and local body fluid samples was 63%. The most frequently detected pathogens were gram-negative bacteria, and Klebsiella pneumonia. There were no significant differences in the clinical features between the pathogens.
CONCLUSION
mNGS is significantly superior to conventional methods in pathogen detection. There was a notable high pathogen consistency detection between blood and local body fluid samples, supporting the clinical relevance of mNGS. This study highlights the superiority of mNGS in detecting a broad spectrum of pathogens quickly and accurately.
TRIAL REGISTRATION
Not applicable.
背景
脓毒症仍然是重症监护病房死亡的主要原因，快速准确的病原体检测对于有效治疗至关重要。本研究评估了多部位宏基因组下一代测序（mNGS）在脓毒症诊断中的临床应用，将其性能与常规方法进行了比较。
方法
对梅州市人民医院重症医学科连续收治的 69 例脓毒症患者进行回顾性分析。采集外周血和感染部位样本进行 mNGS 和传统方法检测，比较 mNGS 和传统病原体检测方法的阳性率及病原体分布。本研究采用的方法包括外周血和感染部位样本中病原体一致性的综合分析。此外，还研究了检测到的病原体与临床结局之间的相关性。
结果
脓毒症患者中，57.97%有呼吸困难，65.2%有基础疾病，最常见的是高血压。mNGS 的病原体检测率（88%）明显高于传统方法检测（26%）。血浆与支气管肺泡灌洗液样本之间的病原体一致性率为 60%，血浆与局部体液样本之间的病原体一致性率为 63%。最常检测到的病原体是革兰氏阴性菌和肺炎克雷伯菌。病原体的临床特征无显著差异。
结论
mNGS 在病原体检测方面明显优于传统方法。血液和局部体液样本之间存在显著的高病原体一致性检测，支持 mNGS 的临床相关性。本研究突出了 mNGS 在快速准确检测广谱病原体方面的优势。
试验注册
不适用。
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