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基于纳米孔序列的元基因组学在临床感染病例下一代序列的预后价值:一项回顾性观察性研究

Yunqi Ji¹, Jing Gu¹, Shuang Xiao¹

¹Department of Infectious Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China.

Diagnostic microbiology and infectious disease

|September 9, 2025

概括

使用纳米孔测序技术 (NST) 的元基因下一代测序 (mNGS) 与传统培养方法相比,在传染病病例中显著降低了28天的死亡率. 通过增加降级率和减少治疗时间,NST还改善了抗生素管理.

科学领域:

传染性疾病传染性疾病
基因组学就是基因组学.
医学诊断医学诊断医学诊断

背景情况:

传染病诊断的传统培养方法在速度和灵敏度方面存在局限性.
下一代元基因组测序 (mNGS) 提供了一个潜在的更快,更全面的诊断方法.
纳米孔测序技术 (NST) 是一个新兴的mNGS平台.

研究的目的:

为了评估mNGS使用纳米孔测序技术 (NST) 与传统培养方法的预后价值.
为了比较使用NST-mNGS和基于培养的方法诊断的患者之间的临床结果,包括28天死亡率.
评估NST-mNGS的诊断准确性和对抗生素管理的影响.

主要方法:

追溯性,单中心观察性研究,比较NST和文化群体.
对于28天死亡率的考克斯比例危险回归和卡普兰-梅尔生存分析.
倾向分数匹配 (PSM) 和强大的多变量考克斯回归用于控制混因素.
在细菌检测中计算NST的灵敏度,特异性,PPV和NPV.

主要成果:

基于NST的诊断独立地与28天死亡率显著降低有关 (HR = 0.29,p = 0.033).
对于细菌检测,NST表现出高灵敏度 (0.93) 和负预测值 (0.94).
在NST组显示较高的抗生素降级率 (ADE) (p=0.0238) 和减少的治疗时间 (DOT) (p=0.008).

结论:

与传统培养相比,基于NST的mNGS在诊断细菌感染方面表现优越.
NST使用和阳性病原体检测与28天死亡率的降低有关.
较高的APACHE II分数预示着更糟糕的预后,强调早期严重性评估.

关键词:

28天死亡率28天死亡率亚太地区的亚太地区II.抗生素降级速度的降级速度诊断性表现诊断性表现纳米孔测序技术的技术.基于纳米孔测序的mNGS.预测值的预测值是指预测值的预测值.

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