宏基因组高通量测序在猪链球菌感染中的应用1例  

Application of metagenomic next-generation sequencing in Streptococcus suis infection:a case report

作　　者：申婷婷 柳晓峰 陈东妙 刘朵朵 王从容 Shen Tingting;Liu Xiaofeng;Chen Dongmiao;Liu Duoduo(Medicine Laboratory of Nanfang Hospital of Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院检验科,广州510515 [2]不详

出　　处：《中华检验医学杂志》2023年第9期955-957,共3页Chinese Journal of Laboratory Medicine

摘　　要：报道1例由宏基因组高通量测序技术(mNGS)诊断的猪链球菌败血症并链球菌中毒性休克综合征。患者男,50岁,于2021年6月25日就诊南方医院增城院区,流行病学史典型,主要临床表现为发热、腹泻、休克,结合血液mNGS诊断为猪链球菌败血症并链球菌中毒性休克综合征。初始采用美罗培南经验性治疗,mNGS结果回报后调整抗菌药物为美罗培南联合克林霉素,后续感染好转,降级抗菌药物为哌拉西林他唑巴坦联合克林霉素。猪链球菌后续经血培养确证。患者后期出现双足足趾干性坏疽和突发性耳聋,经治疗后好转出院。mNGS与传统诊断技术相比,具有及时性和准确性等优势,在严重感染和罕见病原体感染领域中起着关键作用。建议将mNGS和传统的诊断技术相结合,早期诊断、早期治疗。A case of Streptococcus suis sepsis and streptococcal toxic shock syndrome diagnosed by metagenomic next-generation sequencing(mNGS)was presented.A 50-year old male patient visited Zengcheng Branch of Nanfang Hospital on June 25th,2021.The patient developed fever,dizziness and shock with typical epidemiological history.mNGS revealed Streptococcus suis in blood sample.The diagnosis of Streptococcus suis sepsis and streptococcal toxic shock syndrome were made.Meropenem was given as empirical antibiotics.Antibiotics were adjusted to meropenem and clindamycin while Streptococcus suis was detecting by mNGS and downgraded to piperacillin/tazobactam and clindamycin when symptoms improved.The diagnosis was then confirmed by blood culture.The patient developed dry gangrene and sudden deafness in the later stage and was discharged after treatment.Compared with traditional diagnostic techniques,mNGS has advantages such as timeliness and accuracy,and plays a key role in the field of severe infections and rare pathogen infections.It is suggested that combining mNGS and traditional diagnostic techniques have the advantages for early diagnosis and early treatment.

关 键 词：链球菌 猪 感染 宏基因组高通量测序 

分 类 号：R515.3[医药卫生—内科学]