老年细菌性肺炎痰标本的临床应用价值:基于16S rDNA测序方法

Clinical application value of sputum specimens for bacterial pneumonia in the elderly:based on the 16S rDNA sequencing method

目的采用16S rDNA高通量测序技术,比较不同采集方式获得的老年细菌性肺炎患者呼吸道标本的共有或独有细菌,评估质量合格的呼吸道标本的临床价值。方法选取该院收治的10例诊断为细菌性肺炎且未经治疗的老年患者作为研究对象,分别采集自然咳痰(SH组)、纤维支气管镜吸痰(XT组)和纤维支气管镜肺泡灌洗液(XC组)标本,采用16S rDNA高通量测序技术检测并比较3组标本细菌组成的相似性和差异性。结果3组标本共有菌群959个属,3组标本独有细菌的属比较,差异有统计学意义(P<0.05),但非度量多维尺度分析显示,3组标本在属水平上总体细菌结构差异不明显。结论16S rDNA高通量测序SH组标本细菌更丰富,但质量合格的3组标本在属水平上总体细菌结构差异不明显,SH组标本仍有一定的临床价值。

Objective To compare the common or unique bacteria of respiratory tract specimens of elderly patients with bacterial pneumonia obtained by different collection methods by 16S rDNA high-throughput sequencing technology,and to evaluate the clinical value of qualified respiratory tract specimens.Methods Ten untreated elderly patients diagnosed with bacterial pneumonia in the hospital were selected as the research objects.The specimens of natural expectoration(SH group),fiberoptic bronchoscopic sputum aspiration(XT group)and fiberoptic bronchoscopic alveolar lavage fluid(XC group)were collected respectively.16S rDNA high-throughput sequencing technology was used to detect and compare the similarities and differences in bacterial composition of the three groups of specimens.Results There were 959 genera of flora in the three groups.There was significant difference in the genera of unique bacteria among the three groups(P<0.05),but nonmetric multidimensional scale analysis showed that there was no significant difference in the overall bacterial structure at the genus level among the three groups.Conclusion 16S rDNA high-throughput sequencing SH group specimens are more abundant in bacteria,but the overall bacterial structure of the three groups of qualified specimens is not significantly different at the genus level.SH group specimens still have certain clinical value.