mNGS在脓毒症病原体检测和抗生素治疗中的应用  

Application of mNGS in sepsis pathogen detection and antibiotic treatment

作　　者：静亮 彭希[2] 张友平[1] 李大勇[1] 石迎花[1] 祝伟[1] JING Liang;PENG Xi;ZHANG Youping;LI Dayong;SHI Yinghua;ZHU Wei(Department of Emergency-critical Medical,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430000,China;Department of Internal Neurology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430000,China)

机构地区：[1]华中科技大学同济医学院附属同济医院急诊-重症医学科,湖北省武汉市430000 [2]华中科技大学同济医学院附属同济医院神经内科,湖北省武汉市430000

出　　处：《中南医学科学杂志》2022年第3期367-369,共3页Medical Science Journal of Central South China

基　　金：湖北省卫生计生委科研项目(WJ2019M123)。

摘　　要：目的分析宏基因组学下一代测序(mNGS)在脓毒症患者病原体检测和抗生素应用中的临床价值,为疾病快速、准确诊断和改善患者临床预后提供新型诊断技术。方法选择确诊脓毒症患者52例,入院24 h内完成样本(血液、尿液、痰液或者肺泡灌洗液)收集,分别采用传统技术(细菌培养和免疫学方法)和mNGS法进行病原体检测。结果mNGS法诊断病原体的时间比传统法明显缩短,识别率提高,准确率提高(P<0.05)。根据传统技术建议首次采用广谱抗生素,而根据mNGS则推荐使用针对性更强的高效抗生素。结论脓毒症患者采用mNGS法能够缩短病原体检测时间,提高病原体识别率和准确率,可作为指导抗生素应用的依据。Aim To analyze the clinical value of metagenomics next generation sequencing(mNGS)in pathogen detection and antibiotic application in patients with sepsis,so as to provide a new diagnostic technology for rapid and accurate diagnosis of the disease and improving the clinical prognosis of patients.Methods 52 patients with sepsis diagnosed in intensive care unit were selected.Samples(blood,urine,sputum or alveolar lavage fluid)were collected within 24 hours after admission.Pathogens were detected by traditional techniques(bacterial culture and immunological methods)and mNGS respectively.Results The time of diagnosing pathogens in mNGS group was significantly shorter than that in traditional group,and the recognition rate and accuracy were improved(P<0.05).According to the traditional technology,broad-spectrum antibiotics are recommended for the first time,while more targeted and efficient antibiotics are recommended according to mNGS.Conclusion mNGS in patients with sepsis can further shorten the pathogen detection time,improve the pathogen recognition rate and accuracy,and serve as the basis for guiding the application of antibiotics.

关 键 词：宏基因组学下一代测序 脓毒症 病原体 抗生素 

分 类 号：R631[医药卫生—外科学]