用性元基因组下一代测序来有效地识别败血症患者的病原体
Zhendong Chen1, Tingting Ye2, Yuxi He1
1Department of Intensive Care Unit, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
Folia microbiologica
|February 11, 2024
概括
与血液测试相比,样品的甲基因组下一代测序 (mNGS) 显著改善了败血症患者的病原体检测. 这种方法提高了有氧和无氧细菌感染的诊断准确度,有助于更好的临床管理.
科学领域:
- 临床微生物学 临床微生物学
- 传染性疾病 传染性疾病
- 基因组学就是基因组学.
背景情况:
- 血液元基因组下一代测序 (mNGS) 对败血症的病原体检测有局限性.
- 来自感染部位的提供了一个潜在的更丰富的来源,用于识别致病原体.
- 准确和及时的病原体鉴定对于有效的败血症管理至关重要.
研究的目的:
- 为了评估mNGS的诊断价值,使用败血症患者的样.
- 为了比较mNGS与传统种植方法的病原体识别性能.
- 分析与不同类型的无氧感染相关的临床特征.
主要方法:
- 从患有败血症的患者那里收集了35个样.
- 进行的mNGS和培养方法用于病原体识别和混合感染诊断.
- 对mNGS和培养有氧,任意无氧和义务无氧细菌和真菌之间的诊断准确度和灵敏度进行比较.
- 分析了强制性厌氧微生物的起源,并比较了非强制性和强制性厌氧感染组之间的临床特征.
主要成果:
- mNGS显著提高了对有氧/选择性无氧感染的诊断准确性 (94.4%) 和对强制性无氧感染的敏感性 (100.0%).
- mNGS发现了24种混合感染,而只有1种通过培养,突出了其在检测多微生物感染方面的卓越能力.
- mNGS在识别真菌感染方面没有任何优势.
- 牙引起的细菌与肌和皮肤/软组织感染有关,而来自肠道的微生物与腹腔内感染有关.
- 与强制性无氧感染相比,非强制性无氧感染呈现出更高的SOFA得分,前素水平,以及性休克和急性肝损伤比例的增加.
结论:
- 的mNGS是性感染的败血症患者微生物诊断的宝贵工具,比基于血液的方法提供了更好的病原体检测.
- 这项研究证明了mNGS在识别复杂的多微生物感染,特别是那些涉及有约束性无氧生物的有用性.
- 了解厌氧细菌的来源和相关的临床特征可以指导毒症的向治疗策略.
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