通过临床元基因组测序,通过临床元基因组测序改善了毒症或败血症休克时的病原体鉴定
Thorsten Brenner1, Sebastian O Decker2, Yevhen Vainshtein3
1Heidelberg University, Medical Faculty Heidelberg, Department of Anesthesiology, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany; Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany.
The Journal of infection
|August 7, 2025
概括
血中微生物无细胞DNA (mcfDNA) 的下一代测序 (NGS) 为败血症诊断提供了比血液培养 (BC) 更高的病原体检测率. 这种先进的方法显示出在败血症管理中改善患者结果的潜力.
科学领域:
- * 医学诊断 医学诊断 医学诊断
- * 微生物学 微生物学
- * 基因组学 是一个学科.
背景情况:
- * 血液培养 (BCs) 是诊断败血症的黄金标准,但在灵敏度和特异性方面有局限性.
- *目前的败血症诊断方法可能会推迟及时和适当的治疗.
- * 微生物无细胞DNA (mcfDNA) 的无偏向下一代测序 (NGS) 是一种新的病原体识别方法.
研究的目的:
- *为了比较基于NGS的mcfDNA分析的诊断阳性率与败血症患者的标准血液培养 (BCs).
- * 评估NGS发现对抗感染治疗策略的临床可信性和影响.
- * 评估诊断方法与败血症患者结果之间的相关性.
主要方法:
- *进行了一项前性,观察性,多中心研究 (Next GeneSiS-Trial).
- * 血mcfDNA的NGS进行,以确定败血症患者的致病原体.
- * 一个独立的专家小组回顾评估了NGS结果的可信性和治疗适应潜力.
主要成果:
- *NGS在败血症发病后三天内实现了70.5%的病原体鉴定阳性率,明显高于BCs (19.4%).
- * 专家小组的评估认为98.6%的NGS发现是合理的.
- *对NGS结果的了解可能会导致32.6%的患者适应抗感染治疗,对那些治疗不充分的人来说,结果可能更好.
结论:
- * 基于NGS的病原体诊断表明,与标准BC相比,在败血症中表现优越.
- *将NGS整合到败血症诊断中有可能改善患者的治疗结果.
- *NGS提供了一个比传统的微生物学诊断对败血症管理有前途的进步.
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