在免疫功能低下的下呼吸道感染患者中比较靶向测序与元基因组新一代测序的诊断价值。

IF 4.6 2区 医学 Q1 MICROBIOLOGY
Muyun Wei, Shaowei Mao, Shuangshuang Li, Kangyi Gu, Dejian Gu, Shengjie Bai, Xinhua Lu, Min Li
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引用次数: 0

摘要

背景:准确鉴定下呼吸道感染(LRTI)的病因至关重要,尤其是对于病因较为复杂的免疫功能低下患者。新一代测序技术(NGS)的出现提高了病原体检测的有效性。然而,对定向 NGS(tNGS)在免疫功能低下的 LRTI 患者中的临床诊断价值的评估还很有限:为了评估 tNGS 在免疫功能低下的 LRTI 患者中的诊断价值,我们共招募了 88 名患者,其中 54 人免疫功能低下。这些患者接受了支气管肺泡灌洗液(BALF)的 tNGS 检测。所有参与者还都获得了元基因组新一代测序(mNGS)和传统微生物学检测(CMT)的结果。通过将 tNGS 的结果与 mNGS、CMT 和临床综合诊断结果进行比较,评估了 tNGS 的性能:结果:在 88 名患者中,tNGS 的诊断价值与 mNGS 相当,明显优于 CMT。与 CMT 和综合参考标准相比,tNGS 的灵敏度分别为 94.55% 和 90.48%。在免疫力低下的患者中,尽管病原体种类更多,但 tNGS 仍保持了与 mNGS 相似的灵敏度,且优于 CMT。在 72.72% 的病例中,tNGS 对病原学诊断和抗生素决策产生了积极影响,导致 17.05% 的病例改变了抗生素方案。我们还比较了 tNGS 和 mNGS 对微生物核酸的检测,发现 tNGS 可以鉴定出 87.99% 的 mNGS 鉴定出的微生物核酸:总之,我们的研究表明,tNGS 与 CMT、综合参考标准和 mNGS 相比,tNGS 具有良好的临床诊断准确性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparing the diagnostic value of targeted with metagenomic next-generation sequencing in immunocompromised patients with lower respiratory tract infection.

Background: Accurate identification of the etiology of lower respiratory tract infections (LRTI) is crucial, particularly for immunocompromised patients with more complex etiologies. The advent of next-generation sequencing (NGS) has enhanced the effectiveness of pathogen detection. However, assessments of the clinical diagnostic value of targeted NGS (tNGS) in immunocompromised patients with LRTI are limited.

Methods: To evaluate the diagnostic value of tNGS in immunocompromised patients with LRTI, a total of 88 patients, of whom 54 were immunocompromised, were enrolled. These patients underwent tNGS testing of bronchoalveolar lavage fluid (BALF). Results from both metagenomic next-generation sequencing (mNGS) and conventional microbiological tests (CMT) were also available for all participants. The performance of tNGS was assessed by comparing its findings against mNGS, CMT, and the clinical composite diagnosis.

Results: In the cohort of 88 patients, tNGS showed comparable diagnostic value to mNGS and was significantly superior to CMT. Compared to CMT and composite reference standard, tNGS showed sensitivity of 94.55% and 90.48%, respectively. In immunocompromised patients, despite a more diverse pathogen variety, tNGS maintained similar sensitivity to mNGS and outperformed CMT. tNGS positively influenced etiologic diagnosis and antibiotic decision-making in 72.72% of cases, leading to a change in antibiotic regimen in 17.05% of cases. We also compared the detection of microbial nucleic acids by tNGS with mNGS and found that tNGS could identify 87.99% of the microbial nucleic acids identified by mNGS.

Conclusion: In summary, our study demonstrated that tNGS offers promising clinical diagnostic accuracy in immunocompromised patients, as evidenced by its favorable comparison with CMT, the composite reference standard, and mNGS.

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来源期刊
CiteScore
8.60
自引率
0.00%
发文量
49
审稿时长
>12 weeks
期刊介绍: Annals of Clinical Microbiology and Antimicrobials considers good quality, novel and international research of more than regional relevance. Research must include epidemiological and/or clinical information about isolates, and the journal covers the clinical microbiology of bacteria, viruses and fungi, as well as antimicrobial treatment of infectious diseases. Annals of Clinical Microbiology and Antimicrobials is an open access, peer-reviewed journal focusing on information concerning clinical microbiology, infectious diseases and antimicrobials. The management of infectious disease is dependent on correct diagnosis and appropriate antimicrobial treatment, and with this in mind, the journal aims to improve the communication between laboratory and clinical science in the field of clinical microbiology and antimicrobial treatment. Furthermore, the journal has no restrictions on space or access; this ensures that the journal can reach the widest possible audience.
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