高通量测序技术在尿路感染及腹膜透析相关腹膜炎病原学诊断中的价值  

Application of high-throughput sequencing technology in etiological diagnosis of urinary tract infection and peritoneal dialysis-associated peritonitis

作　　者：胡晓熠 汪明[2] 王惠明[1] HU Xiao-yi;WANG Ming;WANG Hui-ming(Department of Nephrology,Renmin Hospital of Wuhan University,Wuhan,Hubei 430060,China;Department of Clinical Laboratory,Renmin Hospital of Wuhan University,Wuhan,Hubei 430060,China)

机构地区：[1]武汉大学人民医院肾内科,湖北武汉430060 [2]武汉大学人民医院检验科,湖北武汉430060

出　　处：《中华实用诊断与治疗杂志》2021年第3期230-233,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家自然科学基金(81370800);湖北省技术创新专项重大项目(2019ACA137)。

摘　　要：目的比较尿路感染、腹膜透析相关腹膜炎患者采用高通量测序技术、常规培养法对病原体的检出情况,探讨高通量测序技术在尿路感染、腹膜透析相关腹膜炎病原学诊断中的应用价值。方法收集77例尿路感染患者中段尿标本,36例腹膜透析相关腹膜炎患者透析流出液标本,分别应用高通量测序技术、常规培养法进行检测,记录病原体检出率及病原体分布情况,以培养法为金标准,计算高通量测序法对病原体检测的灵敏度。结果77例尿路感染患者中,高通量测序法检出病原体70例(90.9%),共分离出病原体169株;培养法检出病原体27例(35.1%),共分离出病原体27株;以培养法为金标准,高通量测序法对尿路感染患者病原体检出的灵敏度为96.3%。36例腹膜透析相关腹膜炎患者中,高通量测序法检出病原体28例(77.8%),共分离出病原体39株,培养法检出病原体11例(30.6%),共分离出病原体11株;以培养法为金标准,高通量测序法对腹膜透析相关腹膜炎患者病原体检出的灵敏度为72.7%。结论对尿路感染、腹膜透析相关腹膜炎患者,采用高通量测序技术检出的病原体株数多于培养法,可作为培养法的有效补充。Objective To compare the detection results of pathogens by high-throughput sequencing technology and ordinary pathogen culture in patients with urinary tract infection and peritoneal dialysis-associated peritonitis,and to investigate the clinical value of high-throughput sequencing technology in the etiological diagnosis of urinary tract infection and peritoneal dialysis-associated peritonitis.Methods The middle urine specimens were collected in 77patients with urinary tract infection,and the peritoneal dialysate was collected in 36patients with peritoneal dialysis-associated peritonitis for high-throughput sequencing and ordinary pathogen culture.The detection rate and the distribution of pathogens were recorded and compared.Taking the culture method as gold standard,the sensitivity of high-throughput sequencing technology to the pathogen detection was calculated.Results In 77patients with urinary tract infection,70 patients(90.9%)were detected 169strains of pathogens by high-throughput sequencing technology;the first three pathogens were Escherichia coli(14.79%),Enterococcus faecium(5.92%)and Enterococcus faecalis(5.92%).The ordinary pathogen culture showed positive in 27patients(35.1%),and 27strains of pathogens were detected;the first three pathogens were Escherichia coli(41.0%),Enterococcus faecium(7.4%)and Klebsiellapneumoniae(7.4%).The detection rate of pathogens in urinary tract infection by high-throughput sequencing technology was higher than that by ordinary pathogen culture(P<0.05).In 36patients with peritoneal dialysis-associated peritonitis,28patients(77.8%)were detected 38strains of pathogens by high-throughput sequencing technology;the first three pathogens were Escherichia coli(10.53%),Aspergillus(10.53%)and Streptococcus(7.89%).The ordinary pathogen culture showed positive in 11patients(30.6%),and 11strains of the pathogen were detected;the first three pathogens were Escherichia coli(27.3%),Staphylococcus aureus(18.2%)and Enterococcus faecium(9.1%).The detection rate of pathogens in patients wit

关 键 词：尿路感染 腹膜透析相关腹膜炎 高通量测序技术 培养法 

分 类 号：R691.3[医药卫生—泌尿科学] R459.5[医药卫生—外科学] R572.2[医药卫生—临床医学]