在肺炎患者中应用有针对性的下一代元基因组测序
Guanjun Ren1, Liyun Ma1, Chunliang Yan1
1Pulmonary and Critical Care Medicine, Beijing Aerospace General Hospital, Beijing, China.
Microbiology spectrum
|June 23, 2025
概括
大基因组下一代测序 (mNGS) 方法,包括基于捕获杂交 (chNGS) 和基于多重PCR的向 (tNGS),显著提高了肺炎诊断的准确性. 结合chNGS和tNGS,为复杂的感染提供了最高的诊断性能.
科学领域:
- 医学微生物学 医学微生物学
- 传染性疾病 传染性疾病
- 基因组学就是基因组学.
背景情况:
- 由于COVID-19大流行,严重肺炎患者的混合感染增加,诊断复杂,死亡率增加.
- 准确和快速诊断肺炎,特别是混合感染,对于有效的患者管理至关重要.
研究的目的:
- 评估基于捕获杂交的mNGS (chNGS) 和基于多重PCR的向mNGS (tNGS) 对肺炎的诊断性能.
- 将mNGS技术与传统的诊断方法进行比较.
主要方法:
- 对110名怀疑肺部感染的患者进行了回顾性评估.
- 用最终的综合性临床诊断作为参考标准进行诊断性能分析.
- 对 chNGS,tNGS 和传统方法的总巧合率 (TCR) 的比较.
主要成果:
- chNGS实现了64.1%的TCR,明显高于传统方法 (39.8%).
- tNGS显示出略高于chNGS的性能,chNGS有更多的假负结果,特别是在病毒病原体.
- 结合的chNGS和tNGS将TCR提高到81.3%.
结论:
- chNGS和tNGS是诊断,管理和排除肺炎感染的宝贵工具.
- 结合chNGS和tNGS,可提高复杂病例的诊断准确度.
- 由于其高度敏感性和较低的经济负担,预计有针对性的mNGS将得到广泛应用.
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