宏基因组新一代测序在深部颈部间隙脓肿治疗指导中的应用
Application of metagenomic next-generation sequencing in treatment guidance for deep neck space abscess.
作者信息
Lei Han, Liao Jiarui, Lin Yu, Liu Tianrun, Lei Wenbin, Gao Wenxiang
机构信息
Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan 2 Road, 510080, Guangzhou, Guangdong, People's Republic of China.
Department of Otorhinolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Shantou University Medical College, No.69 North of Dongxia Road, Shantou, Guangdong, People's Republic of China.
出版信息
BMC Microbiol. 2025 Mar 26;25(1):166. doi: 10.1186/s12866-025-03890-z.
BACKGROUND
Infectious etiologies of deep neck space abscess (DNSA) by conventional culture tests can be challenging, which also leads to frequent irrational antibiotic usage. Metagenomic next-generation sequencing (mNGS), as a novel method for analyzing the complex microbial ecosystem from clinical samples, has been utilized in clinical research and practice of various infectious diseases but deep neck space abscess. We here aimed to explore the clinical value of mNGS for pathogen detection and treatment guidance in DNSA patients compared with conventional culture tests.
METHODS
One hundred six patients diagnosed with DNSA were retrospectively enrolled and allocated into mNGS group and culture group according to whether mNGS was conducted. The pathogen detection effectiveness was of mNGS was compared with conventional culture. Effectiveness of mNGS-modified antimicrobial therapy was evaluated by comparing the treatment outcomes between two groups.
RESULTS
mNGS showed a significantly higher detection rate than conventional culture (p < 0.05) with faster result acquisition. Treatment success rate of patients in the mNGS group was significantly higher than in the culture group (RR: 1.22, 95%CI: 1.07-1.82, p = 0.033). Besides, patients in the mNGS group had shorter duration of irrational antimicrobial therapy, shorter hospital stay and less medical costs (p < 0.05).
CONCLUSIONS
mNGS is an effective technology for facilitating pathogen detection and improving treatment outcomes of DNSA patients.
背景
通过传统培养试验确定深部颈部间隙脓肿（DNSA）的感染病因可能具有挑战性，这也导致抗生素的不合理使用频繁。宏基因组下一代测序（mNGS）作为一种从临床样本中分析复杂微生物生态系统的新方法，已被应用于各种传染病的临床研究和实践，但尚未用于深部颈部间隙脓肿。我们旨在探讨与传统培养试验相比，mNGS在DNSA患者病原体检测和治疗指导方面的临床价值。
方法
回顾性纳入106例诊断为DNSA的患者，根据是否进行mNGS分为mNGS组和培养组。比较mNGS与传统培养在病原体检测方面的有效性。通过比较两组的治疗结果评估mNGS改良抗菌治疗的有效性。
结果
mNGS的检测率显著高于传统培养（p<0.05），且结果获取更快。mNGS组患者的治疗成功率显著高于培养组（RR：1.22，95%CI：1.07-1.82，p=0.033）。此外，mNGS组患者的不合理抗菌治疗持续时间更短、住院时间更短且医疗费用更低（p<0.05）。
结论
mNGS是一种有助于病原体检测并改善DNSA患者治疗结果的有效技术。
Zotero 插件