下一代测序在泌尿器官石头手术的术前评估中的应用
Kantima Jongjitaree1, Tyler Sheetz2, Jamie Finegan2
1Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Journal of endourology
|June 14, 2024
概括
下一代测序 (NGS) 显示了比标准尿液培养更高的灵敏度,用于在尿路结石手术前检测微生物. 结合这两种方法可以改善术后尿路感染 (UTI) 的预测和患者护理.
科学领域:
- 微生物学 微生物学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 分子诊断学 分子诊断
背景情况:
- 细菌尿症治疗对于在尿路结石切除后预防术后尿路感染至关重要.
- 下一代测序 (NGS) 是一种新兴的微生物识别分子技术.
研究的目的:
- 评估手术前尿液NGS测试的实用性.
- 将NGS与标准尿液培养进行比较,以预测术后尿路感染后的尿道透视性石 (URSL) 和皮肤穿透性腎石切除术 (PCNL).
主要方法:
- 对60名接受URSL或PCNL治疗的患者进行前性研究.
- 通过标准尿培养和尿NGS (MicroGenDX) 分析的手术前尿样.
- 在外科手术期间发送用于培养和MicrogenDx的石头样本;在手术后4周内对患者进行感染结果的监测.
主要成果:
- 标准尿液培养在43.3%的病例中检测到微生物,而NGS在51.7%的病例中发现了它们.
- 手术后尿路感染率为10%.
- 尿液NGS表现出较高的灵敏度 (83.3%) 和精度 (55%) 与标准尿液培养相比 (灵敏度为50%,精度为56.7%),尽管特异性相似 (NGS为53.7%,培养为57.4%).
结论:
- 与标准尿液培养相比,尿液NGS显著提高了微生物检测的灵敏度.
- 建议将NGS与标准尿液培养相结合,以利用这两种方法的优势.
- 这种平行方法可以改善接受侵袭性石头手术的高风险患者的护理.
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