肺部感染的老年患者的微生物谱和耐药性概况:基于tNGS的回顾性研究
Guoyan Lei1, Yonggang Hu, Xiaoqin Wu
1Chengdu Xinjin District Hospital of Traditional Chinese Medicine, Chengdu, China.
Medicine
|November 8, 2025
概括
针对性下一代测序 (tNGS) 改善了对老年肺部感染的病原体检测. 菌共同感染显著预测了更长的住院时间和受损的气体交换,突出了tNGS.
科学领域:
- 老年医学 老年医学
- 传染性疾病 传染性疾病
- 分子诊断学 分子诊断
背景情况:
- 在老年人中诊断肺部感染是具有挑战性的,因为免疫和非典型的表现.
- 传统的诊断方法经常无法识别多微生物或机会性病原体.
- 目标下一代测序 (tNGS) 为病原体检测提供了一种敏感和全面的方法.
研究的目的:
- 评估tNGS在怀疑肺部感染的老年患者中识别病原体和抗菌素耐药性基因的实用性.
- 在这个患者队列中确定长时间住院的临床预测因素.
主要方法:
- 使用tNGS对306名老年住院患者的支气管洗液进行了回顾性分析.
- 从电子医疗记录中提取微生物物种,抗微生物耐药性基因和临床数据.
- 卡普兰-梅尔生存分析和极端梯度增强 (XGBoost) 建模用于预测器识别.
主要成果:
- 病毒是最常见的病原体 (29.6%),其次是细菌 (24.4%) 和真菌 (9.0%).
- 同时感染的真菌与长时间住院和改变的血液气体平衡 (升高的PaCO2和HCO3-).
- XGBoost模型确定了PaCO2,prokalcitonin,HCO3−和真菌感染作为长时间住院的关键预测因素.
结论:
- tNGS在老年肺部感染中提供全面的病原体和抗菌素耐药性基因检测.
- 同时感染的真菌和呼吸系统功能障碍显著影响患者的结果和住院时间.
- 将tNGS整合到老年感染管理中可以提高诊断准确性和预后评估.
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