宏基因二代测序技术在化脓性脊柱炎病原学诊断中的应用  

Application of metagenomic next-generation sequencing in pathogenic diagnosis of pyogenic discitis and vertebral osteomyelitis

作　　者：刘飞[1] 祖罡[1] 石仕元[1] 汪翼凡[1] 郑铭锋 魏建 LIU Fei;ZU Gang;SHI Shi-yuan;WANG Yi-fan;ZHENG Ming-feng;WEI Jian(Department of Orthopedics,Hangzhou Red-Cross Hospital,Hangzhou,Zhejiang 310003,China)

机构地区：[1]杭州市红十字会医院骨科,浙江310003

出　　处：《中国骨与关节损伤杂志》2023年第1期39-42,共4页Chinese Journal of Bone and Joint Injury

基　　金：浙江省卫生健康科技计划(2022RC230)。

摘　　要：目的探讨宏基因二代测序(Metagenomic next-generation sequencing,mNGS)技术在化脓性脊柱炎病原学诊断中的应用价值。方法研究纳入自2021-01—2022-03诊治的54例化脓性脊柱炎,将54例标本同时送常规微生物培养及mNGS检测,并比较两种方法检测到的菌种、化脓性脊柱炎病原微生物的阳性检出率、检出时间的差异。结果54例标本中,常规微生物培养检出32例,阳性率59.2%;mNGS技术检出49例,阳性率90.7%;mNGS组检测阳性率明显高于常规微生物培养组,差异有统计学意义(χ^(2)=14.272,P<0.001);检测时间上,mNGS组平均耗时(1.4±0.3)d,短于常规微生物培养组的(7.3±2.5)d,差异有统计学意义(t=9.436,P<0.001)。结论对于化脓性脊柱炎患者,采用宏基因二代测序技术能够更准确而且更早地检测出致病微生物种类,能够为化脓性脊柱炎的诊断及精准治疗提供重要的病原学依据,其临床应用价值较大。Objective To explore the value of metagenomic next-generation sequencing(mNGS)in pathogenic diagnosis ofpyogenic discitis and vertebral osteomyelitis(PDVO).Methods A retrospective analysis was performed on 54 hospitalized pa-tients of PDVO admitted from January 2021 to March 2022.All the 54 specimens were detected with the m NGS and also conven-tional microbial culture method.The detection rate and time as well as bacterial species identified were compared between thetwo methods.Results Among the 54 specimens,32 cases were detected using the conventional microbial culture with the posi-tive rate of 59.2%while 49 cases were detected using the m NGS with the positive rate of 90.7%.The positive rate of m NGS wassignificantly higher than that of conventional microbial culture,the difference was statistically significant(χ^(2)=14.272,P<0.001).The detection time of m NGS(1.4±0.3)d was significantly shorter than that of the conventional microbial culture(7.3±2.5)d,thedifference was statistically significant(t=9.436,P<0.001).Conclusion For the PDVO patients,the m NGS has a higher accura-cy and shorter detection time in detecting the pathogen,which can provide important etiological basis for clinical diagnosis andprecise treatment of PDVO.The mNGS has important value in clinical application.

关 键 词：化脓性脊柱炎 宏基因组 高通量核苷酸测序 病原学诊断 

分 类 号：R681.51[医药卫生—骨科学]