肺泡灌洗液宏基因组二代基因测序在肺炎病原感染谱检测中的意义  

Significance of Metagenomic Next-Generation Sequencing of Broncho-Alveolar Lavage Fluid in Detection of Pneumonia Pathogenic Infection Profile

作　　者：朱丽华[1] 朱波[1] 芮棵 熊御云[1] 夏琳[1] 阴晴[1] ZHU Li-hua;ZHU Bo;RUI Ke;XIONG Yu-yun;XIA Lin;YIN Qing(Department of Laboratory Medicine,Affiliated Hospital of Jiangsu University,Zhenjiang,Jiangsu,212001,China)

机构地区：[1]江苏大学附属医院检验科,江苏镇江212001

出　　处：《中国血液流变学杂志》2022年第3期441-444,共4页Chinese Journal of Hemorheology

基　　金：国家自然科学基金青年项目(81701612)。

摘　　要：目的探讨并评估肺泡灌洗液(BALF)宏基因组二代基因测序(mNGS)在肺炎患者病原感染谱检测中的应用价值,了解镇江地区肺炎患者致病微生物的分布。方法收集2020年6月—2021年6月在江苏大学附属医院住院的56例肺炎患者的BALF标本。对同一份样本分别进行mNGS检测和传统微生物培养,统计其病原微生物的分布情况,并比较两种方法的病原微生物检测结果。结果56例标本中,mNGS结果阳性为45例,主要为细菌,其次为真菌和病毒,其中细菌主要为鲍曼不动杆菌,真菌主要为白假丝酵母菌,病毒主要为巨细胞病毒。传统微生物培养阳性为21例,主要为鲍曼不动杆菌与白假丝酵母菌,与mNGS结果一致。与传统微生物培养相比,mNGS的病原微生物阳性检出率更高(P<0.05)。在混合菌感染时,mNGS比传统微生物培养具有更高的阳性检出率(P<0.05)。结论对于BALF标本,mNGS对细菌与真菌的检出结果与传统培养法较一致,同时还能检出病毒及支原体,为镇江地区提供了常见的肺炎病原感染谱,有利于临床在肺炎病原诊断前做出经验性治疗。Objective To explore the application value of broncho-alveolar lavage fluid(BALF)metagenomic next-generation sequencing(mNGS)in the detection of pathogenic microorganisms in pneumonia patients,and to understand the distribution of pathogenic microorganisms in pneumonia patients in Zhenjiang.Methods BALF specimens of 56 patients with pneumonia hospitalized in the Affiliated Hospital of Jiangsu University between June 2020 and June 2021 were collected.The same sample was tested for mNGS and cultured by conventional microbials,the distribution of pathogenic microorganisms was counted,and the results of pathogenic microbiology tests of the two methods were compared.Results Of the 56 specimens,45 were positive for mNGS,mainly bacteria,followed by fungi and viruses,of which bacteria were mainly Acinetobacter baumannii,fungi were mainly Candida albicans,and viruses were mainly cytomegalovirus.There were 21 positive cases of traditional microbial culture,mainly Acinetobacter baumannii and Candida albicans,which were consistent with mNGS results.The positive detection rate of pathogenic microorganisms in mNGS is higher than that of traditional microbial cultures(P<0.05).In mixed bacterial infection,mNGS has a higher positive detection rate than traditional microbial cultures(P<0.05).Conclusion For BALF specimens,the detection results of mNGS on bacteria and fungi were consistent with traditional microbial cultures,and mNGS can also detect unknown viruses and mycoplasma in BALF specimens,which provided common pneumonia pathogenic infection spectrum for Zhenjiang.It is beneficial to make clinical empirical treatment before the diagnosis of pneumonia pathogens.

关 键 词：肺炎 肺泡灌洗液 宏基因组二代基因测序 

分 类 号：R446.5[医药卫生—诊断学]