宏基因组测序技术在儿童急性淋巴细胞白血病化疗后感染病原体检测中的应用

Application of metagenomic sequencing in detection of pathogens in children with acute lymphoblastic leukemia after chemotherapy

目的探讨宏基因组测序技术在儿童急性淋巴细胞白血病化疗后感染病原体检测中的应用。方法选取本院2018年4月至2019年12月间收治的120例急性淋巴细胞白血病化疗后进入骨髓抑制期发热的患儿,取外周血分别采用宏基因测序检测和培养法检测病原体。对比两种检测方法对病原体检出情况、检出病原体分布。结果培养法与宏基因组测序对病原体的检出率为50.0%(60/120)和63.3%(76/120),差异具有统计学意义(P<0.05);两种方法对细菌、真菌的检出率比较,差异均无统计学意义(均P>0.05),但宏基因组测序技术对病毒的检出率高于培养法(P<0.05);培养法和宏基因组测序技术检出的病原体类型完全一致,但检出的病原体分布存在差异,宏基因组测序技术测得病原体分布高于培养法,但差异无统计学意义(P>0.05)。结论在儿童急性淋巴细胞白血病化疗后感染病原体检测中,利用宏基因组测序技术更为准确,提高了临床病原体的检出率,为制定合理的治疗方案提供信息。

Objective To explore the application of metagenomic sequencing in the detection of infection pathogens in children with acute lymphoblastic leukemia after chemotherapy.Methods One hundred and twenty children with acute lymphoblastic leukemia in myelosuppressive phase of fever who were admitted to our hospital from April,2018 to December,2019 were selected.Their peripheral blood was collected to detect pathogens by metagenomics sequencing and culture.The detection rates and the pathogen distributions by these two methods were compared.Results The detection rate by culture was 50.0%(60/120),and that by metagenomic sequencing 63.3%(76/120),with a statistical difference(P<0.05).There were no statistical differences in the detection rates of bacteria and fungi between these two methods(both P>0.05).The detection rate by viruses by metagenomic sequencing was higher than that by culture(P<0.05).The pathogens detected by these two methods were the same.The pathogen distribution by metagenomic sequencing was higher than that by culture,but with no statistical difference(P>0.05).Conclusion In the detection of pathogens in children with acute lymphoblastic leukemia after chemotherapy,metagenomic sequencing is more accurate.It increases the detection rate of clinical pathogens and provides information for reasonable treatment plans.