宏基因组二代测序技术辅助诊断新生儿埃可病毒18型聚集性感染  

Auxiliary diagnosis for neonatal Echovirus 18 cluster infection by meta-genomic next-generation sequencing technique

作　　者：尚永朋 赵宇曦 邓名贵 欧阳莉丽 彭壬海 李佩玉 余治健 邓启文 SHANG Yong-peng;ZHAO Yu-xi;DENG Ming-gui;OUYANG Li-li;PENG Ren-hai;LI Pei-yu;YU Zhi-jian;DENG Qi-wen(Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging,Shenzhen University Health Science Center,School of Biomedical Engineering,Shenzhen 518052,China;Department of Infectious Diseases,Huazhong University of Science and Technology Union Shenzhen Hospital,The 6th Affiliated Hospital of Shenzhen University Health Science Center,Shenzhen 518052,China)

机构地区：[1]深圳大学医学部生物医学工程学院,广东省生物医学信息检测与超声成像重点实验室,广东深圳518052 [2]华中科技大学协和深圳医院深圳大学医学部第六附属医院感染科,广东深圳518052

出　　处：《中国感染控制杂志》2022年第4期317-322,共6页Chinese Journal of Infection Control

基　　金：深圳市南山区卫生科技计划项目(NS2021009、NS2021140)。

摘　　要：目的探讨宏基因组二代测序(mNGS)技术在医院聚集性感染事件中快速识别感染源的可行性和实用性。方法收集某院新生儿中心6例发热伴腹泻或皮疹新生儿的咽、肛拭子和血标本,同时期同病室其他新生儿和医护人员(咽、肛拭子)标本,以及环境标本,采用传统培养方法、肠道病毒通用聚合酶链反应(PCR)、mNGS和肠道埃可病毒18(ECO18)型特异性PCR进行检测。结果6例新生儿血及肛、咽拭子标本细菌培养未检出病原体,肛拭子肠道病毒通用PCR和ECO18型特异性PCR检测均阳性。mNGS从6例新生儿不同标本中至少一份检出ECO18型病原体,阳性率由高至低依次为肛拭子(66.66%)、血(50.00%)和口咽拭子(0)。采用mNGS检测同时期同病房18例无症状新生儿咽和肛拭子标本,2例新生儿肛拭子标本ECO18型检测阳性。医务人员以及环境标本未检出ECO18型或其他肠道病毒。结论mNGS可检测出ECO18型感染患者粪便或血清中低拷贝数的ECO18型病毒,是一种有效的辅助性诊断肠道病毒感染的方法,并且具有追溯医院聚集性肠道病毒感染病原体的潜力。Objective To explore the feasibility and practicability of metagenomic next-generation sequencing(mNGS)technique in rapid identification of infection sources in hospital-associated cluster infection events.Methods Pharyngeal,anal swabs and blood specimens of 6 neonates with fever and diarrhea(or rash),as well as specimens(pharyngeal and anal swabs)of other neonates and health care workers(HCWs)in the same neonatal center of a hospital during the same period and environmental specimens were collected,traditional culture method,enterovirus universal polymerase chain reaction(PCR),mNGS and Echovirus 18(ECO18)specific PCR were adopted for detection.Results No pathogen was found in the bacterial culture of 6 neonates’blood,anal and pharyngeal swabs,enterovirus universal PCR and ECO18 specific PCR were both positive for anal swabs.At least one specimen from different specimens of 6 neonates was found ECO18 by mNGS,positive rates from high to low were anal swabs(66.66%),blood(50.00%)and pharyngeal swabs(0).The pharyngeal and anal swab specimens of 18 asymptomatic neonates in the same ward during the same period were detected by mNGS,anal swab specimens of 2 cases were positive for ECO18,HCWs and environmental specimens didn’t found ECO18 or other enterovirus.Conclusion mNGS can detect low copy number of ECO18 in feces or serum of patients infected with ECO18,it is an effective auxiliary method for the diagnosis of enterovirus infection,and has the potential to trace the pathogen of hospital cluster enterovirus infection.

关 键 词：新生儿 宏基因组测序 快速诊断 埃可病毒18型 聚集性感染 

分 类 号：R512.9[医药卫生—内科学]