针对性下一代测序用于检测呼吸机相关肺炎中的抗菌素耐药性
Yuting Li1, Yanfang Jiang2, Hao Liu3
1Department of Critical Care Medicine, The First Hospital of Jilin University, Changchun, China.
Frontiers in cellular and infection microbiology
|February 17, 2025
概括
目标下一代测序 (tNGS) 快速准确地识别了呼吸机相关性肺炎 (VAP) 患者的病原体和抗菌素耐药性 (AMR). 这种先进的诊断方法改善了临床管理,并减少了重症监护室 (ICU) 的抗生素滥用.
科学领域:
- 医学诊断 医学诊断 医学诊断
- 基因组测序是指基因组的测序.
- 传染性疾病 传染性疾病
背景情况:
- 呼吸机相关性肺炎 (VAP) 在ICU中具有很高的死亡率,由抗菌素耐药性 (AMR) 加剧.
- 目前的微生物培养速度缓慢,缺乏灵敏度,阻碍了对VAP的及时诊断和有效治疗选择.
- 迫切需要快速准确的诊断工具来检测VAP病原体及其AMR概况.
研究的目的:
- 在疑似VAP病例中评估针对病原体和AMR检测的目标下一代测序 (tNGS) 的性能.
- 将tNGS的结果与传统的微生物培养和抗微生物敏感性测试 (AST) 进行比较.
主要方法:
- 分析了199名ICU患者的样本,其中涉嫌有VAP.
- 对tNGS病原体和AMR检测与微生物培养和AST的比较.
主要成果:
- tNGS在病原体识别方面表现出高灵敏度 (98.98%),显著优于微生物培养 (66.84%).
- 与微生物培养 (3.00天) 相比,tNGS的周转时间要短得多 (1.66天).
- 针对AMR检测的AST和tNGS之间的整体一致性为79.31%,在*Acinetobacter baumannii*中的特定耐药机制方面表现显著.
结论:
- tNGS是一种非常有效的方法来识别VAP病原体及其AMR概况.
- tNGS的快速工作流对于管理重症患者至关重要,使精确的治疗和最大限度地减少抗生素滥用.
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