病原体宏基因检测在器官捐献患者中的应用  

Application of pathogen macrogene detection in organ donation patients

作　　者：潘丽[1] 罗颖 万晓菲 周鑫[1] 叶啟发[1] 潘华勤[1] 徐智高[1] 周威 徐艳[1] Pan Li;Luo Ying;Wan Xiaofei;Zhou Xin;Ye Qifa;Pan Huaqin;Xu Zhigao;Zhou Wei;Xu Yan(Wuhan University Zhongnan Hospital,Wuhan University Liver and Gallbladder Disease Research Institute,Wuhan University Medical Transplantation Center,Wuhan 430071,Hubei,China)

机构地区：[1]武汉大学中南医院,武汉大学肝胆疾病研究院,武汉大学医学移植中心,湖北武汉430071

出　　处：《实用器官移植电子杂志》2024年第2期114-118,共5页Practical Journal of Organ Transplantation(Electronic Version)

摘　　要：目的探讨病原体宏基因组二代测序(metagenomic next-generation sequencing,mNGS)应用于器官捐献者病原微生物的检测,为器官移植后的抗感染药物靶向治疗提供依据。方法回顾性分析了武汉大学中南医院于2021年8月至2023年6月142例器官捐献者的临床病例,收集捐献者的血液样本的mNGS检测和病原微生物培养检测结果,对其进行分析比较。结果142例捐献者中98例在mNGS中检测到病原微生物,阳性检出率为69.01%。其中,59例(60.20%)为单纯病毒感染,12例(12.24%)为单纯细菌感染,4例(4.08%)为单纯真菌感染,混合感染23例(23.47%)。共检测出病原微生物173株。其中,病毒125株(72.25%),细菌40株(23.12%),真菌8株(4.62%)。对捐献者血液样本送检mNGS同时送检微生物培养检测,142例捐献者中20例(14.08%)血培养检测到病原微生物,共检测出21株病原微生物,其中20例(95.24%)为细菌,1例(4.76%)为真菌。器官保存液中培养出病原微生物2例(1.40%)。结论mNGS对病原微生物的检出率高于微生物血培养检测。mNGS检测和血培养病原微生物检测在细菌的诊断上差异不明显,而在检测真菌及病毒阳性时有统计学意义,且mNGS检测比血培养病原微生物检测能大幅度缩短检验时长。Objective To explore the application of metagenomic next-generation sequencing(mNGS)of pathogens in the detection of pathogenic microorganisms in organ donors,and to provide a basis for targeted treatment of anti-infective drugs after organ transplantation.Methods A retrospective analysis was conducted on the clinical cases of 142 organ donors at Central South Hospital of Wuhan University from August 2021 to June 2023.Blood samples from donors were collected for mNGS testing and pathogen culture testing,and the results were analyzed and compared.Results Pathogenic microorganisms were detected in 98 out of 142 donors with mNGS,the positive detection rate was 69.01%.Among them,59 cases(60.20%)were simple viral infections,12 cases(12.24%)were simple bacterial infections,4 cases(4.08%)were simple fungal infections,and 23 cases(23.47%)were mixed infections.A total of 173 strains of pathogenic microorganisms were detected.Among them,there were 125 strains of viruses(72.25%),40 strains of bacteria(23.12%),and 8 strains of fungi(4.62%).Blood samples from donors were sent for mNGS testing and microbial culture testing.Among 142 donors,20 cases(14.08%)detected pathogenic microorganisms in blood culture,and a total of 21 strains of pathogenic microorganisms were detected,of which 20 cases(95.24%)had bacteria and 1 case(4.76%)had fungal infection.Two cases(1.40%)of pathogenic microorganisms were found in organ preservation solution.Conclusion The detection rate of pathogenic microorganisms by mNGS is higher than that by microbial blood culture detection.The difference between mNGS detection and blood culture pathogen detection in bacterial diagnosis is not significant,but there is statistical significance when detecting fungi and viruses.Moreover,mNGS detection can significantly shorten the testing time compared to blood culture pathogen detection.

关 键 词：宏基因组二代测序 病原微生物检测 公民逝世后器官捐献 供者来源性感染 

分 类 号：R446.5[医药卫生—诊断学] R617[医药卫生—临床医学]