摘要
目的分析宏基因二代测序(metagenomics next-generation sequencing,mNGS)技术在儿童发热血流感染中的诊断价值,并为临床合理调整治疗方案提供依据。方法选择2019年1月—2020年3月在海口市人民医院儿科住院治疗的25例临床疑似血流感染的患儿,分别留取标本进行血培养和mNGS病原体检测。比较两种技术的病原体检出结果及阳性率。结果 25例患儿中,血培养检测平均报告时间为3.7 d,检出病原体阳性1例,阳性率为4.0%;mNGS病原检测平均检出报告时间2.3 d,检出病原体阳性13例,阳性率为52.0%,差异有统计学意义(P<0.05)。血培养检出病原体1种,mNGS检出病原体16种,mNGS检出的病原体种类和数量明显高于传统病原学检测。在mNGS检测出阳性的13例患儿中,单一病原体感染6例,多重病原体感染7例,经结合患儿入院前后诊疗情况,采信其中10例结果,维持或调整抗感染治疗方案;另外3例患儿检出不同种类的真菌,考虑与临床表现及相关检查不符,不予采纳检测结果,遂未加用抗真菌药物予以治疗。13名患儿经过积极综合治疗,均痊愈出院。结论宏基因二代测序有助于协助部分发热儿童血流感染的病原学诊断。
Objective To evaluate the diagnostic value of metagenomics next-generation sequencing(mNGS) technology in children with febrile bloodstream infection, and we provide the basis for rational adjustment of clinical treatment plan.Methods Department of Haikou People’s Hospital from January 2019 to March 2020 were selected. The specimens were collected for blood culture and mNGS pathogen detection. The pathogen detection results and positive rates of the two techniques were compared.ResultsAmong the 25 children, the average reporting time was 3.7 days, 1 case was positive in blood culture, and the positive rate of blood culture detection was 4.0%(1/25);the average detection time was 2.3 days, 13 cases were positive in mNGS pathogen detection, and the positive rate of mNGS pathogen detection was 52.0%(13/25), the difference was statistically significant(P<0.05). 1 pathogen was detected by blood culture, 16 pathogens were detected by mNGS, the species and number of pathogen detected by mNGS were significantly higher than traditional pathogenic testing. Among the 13 children with positive mNGS detection, 6 cases of single pathogen infection, and 7 cases of multiple pathogen infection were detected. Based on the diagnosis and treatment of the children before and after admission, we adopted the results of 10 cases, and maintained or adjusted the anti-infective treatment plan according to their mNGS results;the other 3 children were detected with different types of fungi, considering that they were not consistent with the clinical manifestations and related examinations, the test results were not adopted, and antifungal drugs were not added for treatment. 13 children were cured and discharged after active comprehensive treatment.Conclusion partial febrile children.
作者
何波
李渊龙
陈秀灵
逯军
HE Bo;LI Yuang-Long;CHEN Xiu-Lin;LU Jun(Haikou Hospital Affiliated to Xiangya Medical College of Central South University,Haikou,Hainan 570208,China)
出处
《中国热带医学》
CAS
2021年第5期440-444,共5页
China Tropical Medicine
基金
海南省卫生健康行业科研项目(No.19A200090)。
关键词
儿童
血流感染
二代测序
宏基因组学
病原学
Child
bloodstream infection
second-generation sequencing
metagenomics
etiology
