宏基因组二代测序技术在非结核分枝杆菌骨关节感染诊断中应用价值的初步报道  

Metagenomic Next Generation Sequencing applied in diagnosis of osteoarticular nontuberculous mycobacterial infection

作　　者：王度 方心俞[1] 吴百健 黄子达[1] 张超凡[1] 李文波[1] 张文明[1] Wang Du;Fang Xinyu;Wu Baijian;Huang Zida;Zhang Chaofan;Li Wenbo;Zhang Wenming(Department of Bone Tumor&Joint Surgery,The First Affiliated Hospital to Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院骨肿瘤与关节外科,350005

出　　处：《中华创伤骨科杂志》2021年第7期577-582,共6页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金面上项目(82072458);福建省科技厅科技创新联合资金项目(2019Y9136);福建省医学创新课题(2020CXA038)。

摘　　要：目的初步探讨宏基因组二代测序(mNGS)在非结核分枝杆菌(NTM)骨关节感染病原学诊断中的应用价值。方法分析2014年1月至2019年10月间福建医科大学附属第一医院骨肿瘤与关节外科确诊的119例骨关节感染患者资料。所有患者均先采用传统培养,再进行mNGS筛选出病原学检测结果为NTM的患者,根据mNGS病原学检测结果进行优化培养。记录NTM患者的一般资料、传统培养、mNGS和优化培养的结果。结果119例骨关节感染患者中有12例(10.1%,12/119)mNGS结果为NTM感染,男6例,女6例;年龄31~82岁(平均51.1岁);慢生长型NTM 5例,快生长型NTM 7例。采用传统培养方法的初次培养阳性率仅为16.7%(2/12),优化培养的阳性率为66.7%(8/12),其中快生长型NTM的优化培养阳性率为100%(7/7),慢生长型NTM为20.0%(1/5)。结论对于NTM骨关节感染患者而言,传统的培养方法阳性率较低,mNGS技术在病原学精准诊断上有其优势,尤其对于快生长型NTM感染患者。Objective To investigate the value of metagenomic Next-Generation Sequencing(mNGS)in etiological diagnosis of osteoarticular nontuberculous mycobacterial(NTM)infection.Methods From January 2014 to October 2019,119 patients were definitely diagnosed as osteoarticular infection at Department of Bone Tumor&Joint Surgery,The First Affiliated Hospital to Fujian Medical University.All of them underwent conventional culture followed by mNGS to screen out those with NTM infection by the etiological testing.Optimized culture was conducted for NTM infections.Demographic data,and results of conventional culture,mNGS and optimized culture were recorded for patients with NTM infection.Results mNGS showed that 12 of the 119 patients with osteoarticular infection(12/119,10.1%)had NTM infection.They were 6 males and 6 females aged from 31 to 82 years(average,51.1 years).There were 5 cases of slowly-growing mycobacterial type and 7 cases of rapidly-growing mycobacterial type.The positive rate of primary culture was only 16.7%(2/12)by the conventional culture,but increased to 66.7%(8/12)by the optimized culture.The positive rate of optimized culture was 100%(7/7)for the rapidly-growing mycobacterial type and 20%(1/5)for the slowly-growing mycobacterial type.Conclusion As the positive rate of conventional culture is low for patients with osteoarticular NTM infection,mNGS is superior due to its advantage in accurate etiological diagnosis,especially for that of rapidly-growing mycobacterial type.

关 键 词：感染 宏基因组二代测序 非结核分枝杆菌 

分 类 号：R684[医药卫生—骨科学]