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使用下一代测序平台改善细菌新生儿脑膜炎的诊断
Alieke van der Hoeven1, Martha T van der Beek2, Vincent Bekker3
1Department of Medical Microbiology, Leiden University Medical Center, Postzone E4-P, Postbus 9600, 2300 RC, Leiden, The Netherlands. A.vanderHoeven@LUMC.nl.
Infectious diseases and therapy
|July 12, 2023
概括
16S rRNA基因的下一代测序 (NGS) 与传统的脑脊液 (CSF) 培养相比,在婴儿脑膜炎病例中显著提高了细菌病原体检测. 这种先进的分子方法提高了这种关键疾病的诊断准确度.
科学领域:
- 医学微生物学 医学微生物学
- 新生儿传染病 新生儿传染病
- 分子诊断学 分子诊断学
背景情况:
- 婴儿细菌性脑膜炎是一种严重的,危及生命的疾病,需要及时的经验性治疗.
- 传统的脑脊液 (CSF) 培养在检测细菌病原体方面存在局限性,原因是抗生素的影响.
- 与PCR类似的核酸放大试验 (NAATs) 需要对潜在的病原体有事先的了解.
研究的目的:
- 评估一种无培养,广泛的16S rRNA基因下一代测序 (NGS) 平台 (MYcrobiota) 对婴儿细菌脑膜炎的诊断效用.
- 将MYcrobiota的细菌病原体检测率与传统的细菌培养方法进行比较.
主要方法:
- 在三级新生儿重症监护病房进行的回顾性队列研究.
- 在2017年11月至2020年12月期间,分析了35名怀疑患有脑膜炎的婴儿的37个脑脊髓样本.
- 在MYcrobiota (16S rRNA基因NGS) 和常规细菌培养之间比较细菌病原体检测率.
主要成果:
- MYcrobiota在37 (30%) 的脊髓样本中检测到11个细菌病原体.
- 传统的CSF培养在36个 (5.6%) 样本中只在2个样本中发现了细菌.
- NGS证明了细菌病原体的检测率明显更高.
结论:
- 添加16S rRNA基因测序显著改善了细菌性脑膜炎病因的识别.
- 没有培养的NGS在诊断新生儿细菌性脑膜炎方面比传统的脑脊液培养提供了宝贵的进步.
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