摘要
目的 探究宏基因组二代测序(mNGS)在重症肺炎病原学诊断及病情评估中的临床价值。方法 回顾性分析中日友好医院急诊重症监护室重症肺炎病例106例,比较其mNGS检测结果与常规病原学检测结果的一致性,分析mNGS检测结果与实验室检验指标的相关性。结果 以常规病原学检测为金标准,mNGS检测的灵敏度为98.94%,其中检测细菌、真菌、病毒和特殊病原体的灵敏度分别为73.24%、67.31%、70.00%和75.00%,且可更多地检出细菌混合感染(χ^(2)=23.816,P<0.001);mNGS检测识别耐药基因的灵敏度为45.45%。此外,mNGS检出细菌序列数数值(中位数3 620,四分位间距74 434)与白细胞计数[(11.39±6.26)×10^(9)/L]呈正相关(ρ=0.196,P=0.044)。结论 重症监护室中mNGS对重症肺炎病原学诊断价值高,可对病情严重程度进行一定程度的评估,是常规病原学检测的有益补充。
Objective To investigate the clinical value of metagenomics next-generation sequencing(mNGS)in the pathogenic diagnosis and evaluation of severe pneumonia.Methods A retrospective analysis was conducted on 106 cases of severe pneumonia in the emergency intensive care unit of China-Japan Friendship Hospital.The consistency of results between mNGS and conventional pathogen detection was compared,and the correlation between mNGS findings and laboratory test indicators was analyzed.Results Using conventional pathogen detection as the gold standard,the sensitivity of mNGS was 98.94%.The sensitivity for detecting bacteria,fungi,viruses,and special pathogens was 73.24%,67.31%,70.00%,and 75.00%,respectively.mNGS identified bacterial co-infections more frequently(χ^(2)=23.816,P<0.001).The sensitivity of mNGS for detecting antimicrobial resistance genes was 45.45%.Additionally,the numerical value of bacterial sequences detected by mNGS(median:3620,interquartile range:74434)was positively correlated with white blood cell count[(11.39±6.26)×10^(9)/L](ρ=0.196,P=0.044).Conclusion mNGS demonstrates high diagnostic value for severe pneumonia in the intensive care unit and can provide an assessment of disease severity,serving as a valuable complement to conventional pathogen detection methods.
作者
路浩天
史安可
何秀燕
闫圣涛
LU Haotian;SHI Anke;HE Xiuyan;YAN Shengtao(Departments of Emergency,China-Japan Friendship Hospital,Beijing 100020,China)
出处
《中国急救复苏与灾害医学杂志》
2025年第8期1033-1038,1043,共7页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
国家自然科学基金(52342211)。
关键词
宏基因组二代测序
重症肺炎
病原学
耐药基因
病情评估
Metagenomics next-generation sequencing
Severe pneumonia
Etiology
Antimicrobial resistance gene
