评估下一代元基因组测序测试用于感染宿主中的病原体鉴定的诊断效用:一个回顾性队列研究
Austin Williams1, William Zach Webster2, Chao Cai3
1Department of Pharmacy, Prisma Health Midlands, Columbia, SC, USA.
Therapeutic advances in infectious disease
|February 26, 2024
概括
大多数情况下,甲基因组下一代测序 (mNGS) 测试显示出高临床效用,积极的结果显著影响了患者的护理. 咨询医疗主管可以进一步提高诊断价值.
科学领域:
- 传染病诊断 传染病诊断 传染病诊断
- 分子生物学分子生物学
- 临床微生物学 临床微生物学
背景情况:
- 甲基因组下一代测序 (mNGS) 从单个血液样本提供广泛的病原体检测.
- 关于mNGS在临床实践中的诊断实用性的现实数据有限.
- 本研究评估了mNGS测试的实际应用和有效性.
研究的目的:
- 在现实临床环境中确定mNGS测试的诊断效用.
- 为了确定与mNGS结果的高临床实用性相关的因素.
- 评估mNGS对抗微生物治疗决策的影响.
主要方法:
- 在2018年6月至2020年5月期间订购的mNGS测试的回顾性队列研究.
- 纳入标准:针对疑似感染的测试;排除:患者到期,临终关怀或转移.
- 两个独立的研究人员评估了诊断效用;逐步的多重回归确定了与高效用相关的因素.
主要成果:
- 分析了82名患者的80个mNGS测试,58%的患者至少确定了一个潜在的病原体.
- 57.5%的测试被归类为具有高诊断效用.
- 积极的mNGS结果 (78.3%) 和抗菌变化 (67.4%) 与高效益有显著的关联.
结论:
- 在大多数评估的病例中,mNGS测试显示出高临床效用.
- 阳性mNGS测试结果与高诊断效用有很强的相关性.
- 建议咨询医疗主管,以优化mNGS测试的实用性.
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