宏基因二代测序技术鉴定停乳链球菌化脓性腰椎间盘感染1例

A case of pyogenic spondylodiscitis of Streptococcus dysgalactiae diagnosed by mNGS

化脓性腰椎间盘感染是指发生于腰椎间盘和邻近椎体的炎症性病变,致病菌以阳性菌多见。本研究报告南京医科大学附属宿迁第一人民医院骨科收治的1例62岁男性患者,腰痛伴双下肢放射痛1月余,腰椎核磁共振(MRI)提示化脓性腰椎间盘感染,经验性静脉注射莫西沙星效果不佳,常规微生物培养(外周血和引流液)结果为阴性,椎间隙组织送宏基因二代测序(metagenomic next-generation sequencing,mNGS)结果提示链球菌属停乳链球菌感染,予以青霉素等治疗后患者病情好转。

Pyogenic spondylodiscitis refers to the inflammatory disease occurring in the lumbar disc and adjacent vertebral bodies,and the pathogenic bacteria are mostly positive bacteria.We reported a 62-year-old male patient admitted to the department of orthopedics in The Affiliated Suqian First People's Hospital of Nanjing Medical University,complained of low back pain with radiating pain in both lower extremities for more than one month.Lumbar magnetic resonance imaging(MRI)suggested pyogenic spondylodiscitis,and empirical intravenous moxifloxacin was not effective.The results of conventional microbial culture(peripheral blood and drainage fluid)were negative.The result of metagenomic next-generation sequencing(mNGS)of intervertebral disc tissue indicated Streptococcus dysgalactiae infection,and the condition improved after receiving penicillin and other treatments.