肺炎诊断中的元基因组学:系统性审查
Samuel Quarton1,2, Alana Livesey2, Charlotte Jeff1
1National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, Institute of Translational Medicine, BInstitute of Translational Medicine, Birmingham, UK.
甲基因组下一代测序 (mNGS) 比传统方法更快地识别更多的肺炎病原体. 然而,研究的局限性意味着不同的肺炎类型或样本的临床影响和实用性需要进一步调查.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 基因组学就是基因组学.
背景情况:
- 肺炎是疾病和死亡的重要原因,通常没有确定的致病因子.
- 下一代元基因组测序 (mNGS) 提供了改善肺炎病原体检测的潜力.
- 在肺炎亚型和样本类型中mNGS的临床影响和实用性仍然不清楚.
研究的目的:
- 系统地审查和比较下一代元基因组测序 (mNGS) 与常规微生物学用于肺炎诊断.
- 评估病原体识别,周转时间和临床影响的差异.
- 评估mNGS在各种肺炎亚型和临床样本中的相对实用性.
主要方法:
- 对对肺炎患者的mNGS和常规微生物学进行比较的研究进行系统审查.
- 在EMBASE,MEDLINE,Scopus和CENTRAL数据库中进行了搜索.
- 包括所有研究类型,除了不到10人的病例报告;使用QUADAS-2评估偏差风险.
主要成果:
- 纳入了10566名参与者的74项研究,所有这些研究都有高偏差风险或适用性问题.
- mNGS在78.9%的病例中发现了病原体,而传统测试的病原体为43.2%.
- mNGS显示了显著更快的周转时间 (MD-73.6小时),但对其他结果的元分析是不可能的. 支气管洗液 (BALF) 是主要的样品类型.
结论:
- mNGS可能比标准技术更频繁地检测病原体,但研究偏差限制了临床相关性的最终结论.
- 需要进一步的研究来评估与mNGS相关的临床结果.
- 在特定的肺炎亚型和非BALF样本中mNGS的差异性影响需要研究.
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