宏基因组二代测序技术在社区获得性肺炎中的临床应用体会

Clinical application of metagenomic next-generation sequencing technology in community-acquired pneumonia

目的:探讨宏基因组二代测序技术(mNGS)在社区获得性肺炎中的临床应用价值。方法:回顾性分析2020年12月—2021年12月因社区获得性肺炎在太原市中心医院呼吸与危重症医学科住院的26例患者的临床资料,对传统病原学检测方法与宏基因组二代测序检测方法进行对比研究,比较两者结果的一致性。结果:研究共收集26份标本,传统微生物培养法共检出13份阳性,mNGS共检出23份阳性,mNGS灵敏度(88.5%)高于微生物培养灵敏度(50.0%),差异有统计学意义(P=0.007)。在致病菌检出方面,mNGS共检出细菌20种,真菌7种,病毒9种以及寄生虫1种;微生物培养共检出细菌5种,真菌5种。结论:与传统的微生物培养法相比,mNGS法检测敏感性更高,对病原体的检出能力更强,在呼吸系统感染性疾病的诊治中将发挥重要作用。

Objective: To investigate the value of metagenomic next-generation sequencing(mNGS) technology in the diagnosis of community-acquired pneumonia.Methods: The medical histories of 26 patients with community-acquired pneumonia hospitalized in the Department of Respiratory and Critical Care Medicine of Taiyuan Central Hospital between December 2020 and December 2021 were retrospectively analyzed, and the consistency of results between traditional pathogenic detection methods and mNGS was examined statistically.Results: A total of 26 specimens were collected in the study.Thirteen samples were detected positive by the traditional microbial culture method and 23 samples were detected positive by mNGS.mNGS had a higher sensitivity(88.5%) than microbial culture(50.0%),and the difference between the two methods was statistically significant(P=0.007).For pathogen detection, mNGS detected a total of 20 bacterial species, 7 fungal species, 9 viral species, and 1 parasite species, whereas microbial culture detected a total of 5 bacterial species and 5 fungal species.Conclusion: Compared with traditional microbial culture method, mNGS has higher sensitivity and better ability to detect pathogens, and will play an important role in the diagnosis and treatment of infectious diseases of the respiratory system.