16S rRNA及ITS基因测序在肾移植受者泌尿系感染病原微生物检测中的意义  

Clinical values of 16S rRNA and ITS gene sequencing for pathogenic identification of renal transplant recipients with urinary tract infection

作　　者：崔乃千 周易[1] 邓文锋[1] 肇恒瑞 章媛 夏仁飞[1] 刘如敏[1] 徐健[1] 苗芸[1] Cui Naiqian;Zhou Yi;Deng Wenfeng;Zhao Hengrui;Zhang Yuan;Xia Renfei;LiuRumin;Xu Jian;Miao Yun(Southern Hospital,the First Clinical Medical College,Southerm Medical University,Guangzhou 510515,China;Department of Laboratory Medicine,Southern Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院南方医科大学第一临床医院,广州510515 [2]南方医科大学南方医院检验科,广州510515

出　　处：《中华器官移植杂志》2020年第7期393-397,共5页Chinese Journal of Organ Transplantation

基　　金：广东省自然科学基金(2020A1515010674);广州市科技计划项目(201803010109);南方医院院长基金(2018B009,2018C003)

摘　　要：目的探索对细菌16S rRNA区域和真菌内源转录间隔区(ITS)二代测序技术(NGS)在肾移植受者泌尿系感染(UTI)病原微生物检测中的应用价值。方法收集2017年1月至2019年12月在南方医科大学附属南方医院就诊的90例肾移植受者UTI中段尿标本,对同一份样本分别进行NGS微生物检测和传统尿培养,比较两者病原学检测结果。结果 90例样本中,有21例样本因培养出3种及以上微生物而考虑被污染;余69例样本中,16S rRNA基因测序结果阳性36例(52.17%),尿细菌培养检测阳性25例(36.23%),两者比较差异有统计学意义(P<0.05);ITS基因测序结果阳性34例(49.28%),尿真菌培养检测阳性4例(5.80%),两者比较差异有统计学意义(P<0.05)。结论对于肾移植受者UTI的中段尿样本,NGS技术较尿微生物培养有更高的细菌和真菌检出率。随着NGS检测费用的降低,传统尿培养和NGS微生物检测技术的结合可以提高病原微生物的检出率和准确性,更好地进行移植受者泌尿系感染的个体化治疗。Objective To explore the clinical values of next-generation sequencing(NGS)in bacterial 16S rRNA region and fungal ITS region for diagnosing and treating urinary tract infection(UTI)in renal transplant recipients.Methods A total of 90 mid-stream clean-catch urine samples were collected from renal transplant recipients who were diagnosed with UTI at Hospital from January 2017 to December 2019.Each sample was equally divided and tested via NGS method and traditional urine culture separately.The results of pathogen test and detection rate were analyzed and compared.Results And 21/90 sample were considered to be contaminated due to the identification of three or more kinds of microorganisms by culture.And among the remaining 69 samples,36(52.17%)cases tested positive by 16S rRNA sequencing,25(36.23%)positive by urine bacterial culture;meanwhile,34(49.28%)tested positive by ITS sequencing and 4(5.80%)positive by urine fungal culture.Conclusions The detection rate of both bacteria and fungi in NGS microorganism testing is higher than that in traditional urine culture(P<0.05).For renal transplant recipients with UTI,NGS microorganism testing is an effective supplement for traditional urine culture.Improving the detection rate and accuracy of etiology may enable an optimization of individualized treatment.

关 键 词：肾移植:病原微生物 测序技术 

分 类 号：R699.2[医药卫生—泌尿科学] R691.3[医药卫生—外科学]