mNGS应用背景下的下呼吸道感染病原学检测基础能力

Basic competence for etiological diagnosis of lower respiratory tract infection after application of metagenomic next-generation sequencing

除临床表现、病史、影像学外,下呼吸道感染(LRTI)的诊断水平主要依赖于临床微生物学实验室病原学检测能力,但常规培养耗时长,显微镜检的敏感度低,PCR等分子生物学检测方案覆盖的病原类别有限。近年来宏基因组测序(mNGS)技术的应用提高了LRTI的诊断率,从而也出现对常规微生物检测能力不重视的现象。本文对如何适当使用上述检测方法加以评述,并建议在mNGS背景下,进一步加强临床微生物检测能力的建设。

In addition to clinical manifestations,medical history,and imaging,the diagnosis of low respiratory tract infection(LRTI)depends mainly on the ability of the clinical microbiology laboratory to detect the pathogens.However,conventional culture may be time-consuming,the sensitivity of microscopy is low,and nucleic acid-based targeted tests(e.g.,PCR)could only cover limited range of pathogens.The use of mNGS technology has improved the diagnostic rate of LRTI,but the conventional microbiology detection has been neglected to some extent.This review addressed the appropriate use of these methods with the aim of strengthening the ability of traditional microbiology methods in LRTI diagnosis after mNGS application.