宏基因组二代测序在新生儿感染性疾病诊疗中的临床应用  

Clinical application of metagenomic next-generation sequencing in the diagnosis and treatment of neonatal infectious diseases

作　　者：邱梅冰[1] 蓝秋慧 聂意军 覃婷婷 杨彤[1] QIU Meibing;LAN Qiuhui;NIE Yijun;QIN Tingting;YANG Tong(Department of Paediatrics,Liuzhou People's Hospital,Liuzhou,Guangxi 545006,China)

机构地区：[1]柳州市人民医院儿科,广西柳州545006

出　　处：《医药前沿》2025年第5期1-4,共4页Journal of Frontiers of Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200035)。

摘　　要：目的观察宏基因组二代测序(mNGS)在新生儿感染性疾病诊疗中的应用情况。方法回顾性分析2020年1月—2023年12月柳州市人民医院新生儿科住院的53例诊断为感染性疾病的新生儿临床资料,收集的53份检验标本(20份血液标本,11份脑脊液标本,22份呼吸道分泌物标本)分别进行传统微生物培养及mNGS检测。观察不同标本的培养结果,比较传统微生物培养法和mGS对不同标本的病原体检出情况;观察根据病原学检查结果调整抗菌药应用情况。结果53份检验标本中,传统微生物培养法病原体检测阳性13例(24.5%),mNGS病原体检测阳性37例(69.8%),mNGS病原体检测阳性率高于传统微生物培养法(P<0.05)。mNGS对不同标本的检测结果提示,血液病原体检测阳性9例(45.0%),脑脊液病原体检测阳性8例(72.7%),呼吸道分泌物病原体检测阳性20例(90.9%),差异有统计学意义(P<0.05)。在mNGS检测结果指导下,41例患儿调整治疗方案,其中,10例患儿停用抗菌药,17例患儿升级抗菌药,2例患儿降级抗菌药,10例患儿加用其他抗菌药治疗,2例患儿更换抗菌药。结论mNGS较传统微生物培养法有更高的病原体检测阳性率,mNGS结果对指导临床抗菌药治疗具有重要作用。Objective To observe the application of metagenomic next-generation sequencing(mNGS)in the diagnosis and treatment of neonatal infectious diseases.Methods The clinical data of 53 neonates diagnosed with infectious diseases in the Department of Neonatology in Liuzhou People's Hospital from January 2020 to December 2023 was retrospectively analyzed.Traditional microbial culture and mNGS detections were performed in 53 test specimens(20 blood specimens,11 cerebrospinal fluid specimens,and 22 respiratory secretion specimens).The culture results of different specimens were observed,and the detected pathogen conditions were compared between traditional microbial culture method with mGS method.The adjustment consitions of antibiotic application according to the results of etiological examination were also observed.Results Among the 53 test specimens,13 cases(24.5%)were positive by traditional microbial culture method,while 37 cases(69.8%)were positive by mNGS detection.The positive rate of pathogens detection by mNGS was higher than that by traditional microbial culture method(P<0.05).The detection results of different specimens by mNGS showed that 9 cases(45.0%)were positive for blood pathogens,8 cases(72.7%)were positive for cerebrospinal fluid pathogens,and 20 cases(90.9%)were positive for respiratory tract secretion pathogens,and the differences were statistically significant(P<0.05).Under the guidance of mNGS detected results,41 children adjusted the treatment plans.Among them,10 children discontinued antibiotics,17 children upgraded antibiotics,while 2 children downgraded antibiotics,10 children were treated with other antibiotics,and 2 children changed antibiotics.Conclusions The mNGS has a higher positive rate of pathogen detection than that by traditional microbial culture method.The results of mNGS detection play an important role in guiding clinical antibiotic treatment.

关 键 词：新生儿 感染性疾病 高通量测序 宏基因组 二代测序 抗菌药 

分 类 号：R722[医药卫生—儿科]