临床宏基因组测序中正常有菌部位临床标本的处理办法

Treatment methods of clinical specimens of normal bacteria in mNGS

病原宏基因组高通量测序(mNGS)能覆盖较大范围的病原体,病毒、细菌、真菌、寄生虫都能被同时检测,不论临床样本培养成功与否,只要含有可检测到的DNA或RNA即可。各专家共识中指出各部位感染均具有一定的临床价值,要结合不同标本类型与检出病原微生物的种类进行解读。虽然无菌部位标本的诊断价值优于正常有菌部位,但是正常有菌部位(如呼吸道、尿液、开放性伤口等)样本病原的检测在感染性疾病诊断中也是必不可少的。有菌部位样本复杂多样,为提高检测结果的灵敏性,在不影响样本中病原体含量的前提下会采用不同的方法对样本进行处理。为方便医疗工作者及科研人员了解具体的处理办法,本文对主要的有菌部位样本(鼻咽拭子、肺泡灌洗液、痰液、粪便、尿液、牙菌斑和唾液)处理方法进行综述。

Pathogen metagenomic next-generation sequencing(mNGS)can cover a wide range of pathogens.Viruses,bacteria,fungi,and parasites can be detected at the same time.Whether the clinical samples are successfully cultured or not,as long as they contain DNA or RNA,they can be detected.The consensus of various experts pointed out that the infection of each site has certain clinical value,and the interpretation should be combined with the types of different specimens and the types of pathogenic microorganisms detected.Although the diagnostic value of aseptic part specimens is better than that of normal bacterial parts,the detection of pathogens in samples from normal bacterial parts(such as respiratory tract,urine,open wounds,etc.)is also essential in the diagnosis of infectious diseases.Samples of bacterial parts are complex and diverse.In order to improve the sensitivity of the detection results,different methods will be used to process the samples without affecting the pathogen content in the samples.In order to facilitate medical workers and scientific researchers to understand the specific treatment methods,this article reviews the treatment of the main bacterial samples(nasopharyngeal swabs,alveolar lavage fluid,sputum,feces,urine,dental plaque and saliva)method.