摘要
目的探讨宏基因组二代测序(mNGS)在儿童感染性疾病病原微生物检测中的应用价值,并分析其临床特点.方法采用回顾性研究方法,选择2023年1月至2024年1月在杭州市红十字会医院采用mNGS进行病原微生物检测的30例患儿作为研究对象,并以30例未行mNGS检测的患儿作为对照组.收集两组患儿的临床资料,包括性别、年龄、住院时间、症状和体征、血常规、C-反应蛋白(CRP)、影像学检查、mNGS病原微生物检测结果、转归情况等,对比分析mNGS检测与常规微生物检测(CMT)方式结果的差异,以及mNGS检测对儿童感染性疾病治疗与住院时间的影响.结果30例行mNGS检测的患儿中,男性21例,女性9例,年龄1岁5个月~12岁9个月,平均(7.15±3.13)岁,mNGS检出9种病毒,10种革兰阳性菌,5种革兰阴性菌,3种真菌,以及5种特殊病原体,12例患儿根据检测结果调整了抗感染治疗方案,平均住院时间(10.63±3.15)d,对照组7例患儿调整了治疗方案,平均住院时间(12.64±2.79)d,mNGS组平均住院时间较对照组明显缩短(P<0.05).结论感染患儿症状和体征缺乏特异性,CMT效果不理想,而mNGS技术对病原检测具有较高的敏感度,在CMT未能检出病原时,对病原学诊断和指导用药方面有较高价值,但需要结合临床表现及其他辅助检查对mNGS结果进行判读.
Objective To investigate the clinical value of metagenomic next-generation sequencing(mNGS)in the detection of pathogenic microorganisms in pediatric infectious diseases and to analyze the clinical characteristics of relevant cases.Methods A retrospective analysis was conducted on 30 pediatric patients who underwent mNGS pathogen detection in Hangzhou Red Cross Hospital from January 2023 to January 2024,along with 30 patients who did not undergo mNGS testing as the control group.Clinical information,including age,gender,hospital stay,symptoms and signs,routine blood tests,C-reactive protein(CRP),imaging findings,mNGS pathogen detection results,and patient outcomes,was collected.The differences between mNGS and conventional microbiological testing(CMT)results were compared,and the impact of mNGS testing on infection treatment and hospitalization duration was analyzed.Results Among the 30 patients who underwent mNGS testing,21 were male and 9 were female;with an age range of 1 year 5 months to 12 years 9 months,mean age:(7.15±3.13)years.The mNGS test identified 9 viruses,10 Gram-positive bacteria,5 Gram-negative bacteria,3 fungi,and 5 specific pathogens.Based on the test results,12 patients had their anti-infective treatment plans adjusted,with an average hospital stay of(10.63±3.15)days.In the control group,7 patients had their treatment plans adjusted,with an average hospital stay of(12.64±2.79)days.The average hospital stay was significantly shorter in the mNGS group compared to the control group(P<0.05).Conclusions The clinical symptoms and signs of pediatric infectious diseases often lack specificity,and CMT methods are suboptimal.mNGS exhibits high sensitivity for pathogen detection and demonstrates significant value in etiological diagnosis and therapeutic guidance when CMT fails to identify pathogens.However,interpretation of mNGS results requires integration with clinical presentations and other auxiliary diagnostic findings.
作者
姜琦俊
詹璐
陈园园
Jiang Qijun;Zhan Lu;Chen Yuanyuan(Department of Pediatrics,Hangzhou Red Cross Hospital,Hangzhou 310003,Zhejiang,China;Department of Tuberculosis,Hangzhou Red Cross Hospital,Hangzhou 310003,Zhejiang,China)
出处
《中国中西医结合急救杂志》
2025年第1期43-47,共5页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
国家自然科学基金青年科学基金项目(82104236)。
关键词
感染性疾病
宏基因组二代测序
病原体
Infectious diseases
Metagenomic next-generation sequencing
Pathogens
