基于重症监护病房血样的宏基因组下一代测序在脓毒症患者病原体检测中的临床疗效

Clinical efficacy of metagenomic next-generation sequencing for pathogen detection in septic patients based on blood samples in intensive care units.

作者信息

Lin Tianlai, Liu Xinzheng, Wu Licong, Wu Qingqing, Zeng Haiwen, Li Wushuang, Tang Hui, Zhao Jiangman, Ding Zhirong

机构信息

Department of Intensive Care Unit, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, 362000, Fujian, China.

Department of Clinical Laboratory, Huanghe Sanmenxia Hospital Affiliated to Henan University of Science and Technology, Sanmenxia, 472000, Henan, China.

出版信息

Indian J Med Microbiol. 2025 Jul-Aug;56:100897. doi: 10.1016/j.ijmmb.2025.100897. Epub 2025 Jun 20.

DOI:10.1016/j.ijmmb.2025.100897

PMID:40544959

Abstract

BACKGROUND

Metagenomic next-generation sequencing (mNGS) is considered superior to traditional culture for pathogen detection. However, its utility in septic patients based on blood samples remains limited.

METHODS

This research aimed to compare mNGS and culture-based diagnostics in 78 septic patients, with 25 with sepsis and 53 with septic shock.

RESULTS

Among 68 cases with matching sample types, pathogens of 38 cases were solely identified through mNGS, and in contrast, 2 cases had their pathogens detected by microbiological culture only. Moreover, 17 of 63 cases (26.98 %) were found to be positive by both mNGS and culture, and 6 of 63 cases (9.52 %) came negative under both diagnostic methods. Regardless of prior antibiotic exposure, the positive rate of mNGS, which was 80.77 %, was significantly higher than that of culture (37.18 %). Significantly, among the 38 septic patients diagnosed solely by mNGS, 23 patients achieved a favorable outcome after physicians adjusted the treatment based on the mNGS findings.

CONCLUSION

In conclusion, mNGS offered a swift and accurate means for pathogen identification, and thus making this approach as a promising technology for detecting sepsis.

摘要

背景

宏基因组下一代测序（mNGS）在病原体检测方面被认为优于传统培养方法。然而，其基于血液样本在脓毒症患者中的应用仍然有限。

方法

本研究旨在比较78例脓毒症患者（25例脓毒症患者和53例脓毒性休克患者）的mNGS和基于培养的诊断方法。

结果

在68例样本类型匹配的病例中，38例病例的病原体仅通过mNGS鉴定，相比之下，2例病例的病原体仅通过微生物培养检测到。此外，63例病例中有17例（26.98%）mNGS和培养均呈阳性，63例病例中有6例（9.52%）在两种诊断方法下均为阴性。无论先前是否使用过抗生素，mNGS的阳性率为80.77%，显著高于培养的阳性率（37.18%）。值得注意的是，在仅通过mNGS诊断的38例脓毒症患者中，23例患者在医生根据mNGS结果调整治疗后取得了良好的疗效。