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增强血流感染诊断:一种用于精确病原体鉴定的新型过滤和靶向新一代测序方法。

Enhancing bloodstream infection diagnostics: a novel filtration and targeted next-generation sequencing approach for precise pathogen identification.

作者信息

Lin Ting-Syuan, Zhu ZiHao, Lin XiaoHong, Huang Hsi-Yuan, Li Li-Ping, Li Jing, Ni Jie, Li PeiZhi, Chen LanChun, Tang WeiXin, Liu HuiXin, Se XiaoLong, Xie MingFei, Long Canling, Chiu Chih-Min, Fang Szu-Han, Zhao JiaMing, Lin Yang-Chi-Dung, Yu XueTao, Huang Hsien-Da

机构信息

School of Medicine, The Chinese University of Hong Kong, Shenzhen, Guangdong, China.

Warshel Institute for Computational Biology, School of Medicine, The Chinese University of Hong Kong, Shenzhen, Guangdong, China.

出版信息

Front Microbiol. 2025 Mar 20;16:1538265. doi: 10.3389/fmicb.2025.1538265. eCollection 2025.

Abstract

Bloodstream infections (BSIs) pose a significant diagnostic challenge, largely due to the limitations of traditional methods such as blood cultures. These methods often yield low positive rates, have lengthy processing times that delay treatment, and are limited in detecting only a narrow range of pathogens. Such delays and inaccuracies can critically impede timely clinical interventions, potentially compromising patient outcomes. Next-generation sequencing (NGS) is a powerful tool for rapid, precise pathogen identification. While metagenomic NGS (mNGS) offers broad pathogen coverage, it is often costly and complex. Targeted NGS (tNGS), however, focuses on key regions of clinically relevant pathogens, reducing costs and simplifying workflows while maintaining high sensitivity, making it more practical for routine diagnostics. In this study, we introduce a novel approach combining a human cell-specific filtration membrane with a multiplex tNGS panel to overcome these challenges. The filtration membrane, designed with surface charge properties to be electrostatically attractive to leukocytes for the selective capture of specific cells, demonstrated high efficiency in removing host cells and nucleic acids, achieving over a 98% reduction in host DNA and thereby minimizing background interference in pathogen detection. Additionally, we developed an effective multiplex tNGS panel targeting over 330 clinically relevant pathogens and verified its consistency with mNGS and blood culture results, demonstrating a significant improvement in detection sensitivity. By integrating these two methods, we achieved a synergistic enhancement in diagnostic capability, boosting pathogen reads by 6- to 8-fold, which enabled reliable identification even in cases of low-abundance pathogens. This approach provides faster, more accurate, and more sensitive detection of BSIs, enabling earlier identification of infections. This facilitates timely and targeted treatment, ultimately improving patient outcomes in critical care settings. Given the unique properties of the filtration membrane and the strengths of the tNGS panel, this approach shows promising applications in prenatal and genetic health support, as well as in advancing early cancer screening strategies.

摘要

血流感染(BSIs)带来了重大的诊断挑战,这主要归因于传统方法(如血培养)的局限性。这些方法往往阳性率较低,处理时间冗长,会延误治疗,并且在检测病原体的范围上也很有限。这种延误和不准确会严重阻碍及时的临床干预,可能危及患者的治疗结果。下一代测序(NGS)是一种用于快速、精确鉴定病原体的强大工具。虽然宏基因组NGS(mNGS)能覆盖广泛的病原体,但通常成本高昂且操作复杂。然而,靶向NGS(tNGS)专注于临床相关病原体的关键区域,在保持高灵敏度的同时降低了成本并简化了工作流程,使其在常规诊断中更具实用性。在本研究中,我们引入了一种新颖的方法,将人细胞特异性过滤膜与多重tNGS检测板相结合以克服这些挑战。该过滤膜通过表面电荷特性设计,对白细胞具有静电吸引力,可选择性捕获特定细胞,在去除宿主细胞和核酸方面表现出高效性,实现了宿主DNA减少98%以上,从而最大限度地减少了病原体检测中的背景干扰。此外,我们开发了一种有效的多重tNGS检测板,可靶向330多种临床相关病原体,并验证了其与mNGS和血培养结果的一致性,显示出检测灵敏度有显著提高。通过整合这两种方法,我们实现了诊断能力的协同增强,使病原体读数提高了6至8倍,即使在低丰度病原体的情况下也能实现可靠鉴定。这种方法能更快、更准确且更灵敏地检测血流感染,实现对感染的早期识别。这有助于及时进行有针对性的治疗,最终改善重症监护环境下患者的治疗结果。鉴于过滤膜的独特特性和tNGS检测板的优势,这种方法在产前和遗传健康支持以及推进早期癌症筛查策略方面显示出有前景的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5210/11965694/aea710491f28/fmicb-16-1538265-g001.jpg

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