宏基因组二代测序在肺部感染诊断中的应用与挑战

Application and challenge of metagenomic next-generation sequencing in the diagnosis of pulmonary infection

肺部感染的发病率与病死率在世界感染性疾病中处于高位,快速准确的病原学诊断是进行及时且有效治疗的关键。宏基因组二代测序(metagenomic next-generation sequencing,mNGS)技术突破了传统病原微生物检测方法的局限,提高了病原体的检出率。该文对mNGS技术在肺部的细菌、真菌、病毒及混合感染诊断中的应用及优势进行分析,并对其在RNA检测、厚壁菌破壁及宿主DNA清除等方面面临的挑战和突破进行阐述,以期通过mNGS实现靶向、精准的病原学诊断,从而有效治疗肺部感染。

The morbidity and mortality of pulmonary infection are high among infectious diseases worldwide.Rapid and accurate etiological diagnosis is the key to timely and effective treatment.Metagenomic next-generation sequencing(mNGS)technology has broken through the limitations of traditional pathogenic microorganism detection methods and improved the detection rate of pathogens.In this paper,the application and advantages of mNGS technology in the diagnosis of bacteria,fungi,viruses and mixed infections in the lungs are analyzed,and the challenges and breakthroughs in RNA detection,wall breaking of firmicutes and host DNA clearance are described,in order to achieve targeted and accurate etiological diagnosis through mNGS,so as to effectively treat pulmonary infections.