小儿重症监护病房重症肺炎患儿气管吸入宏基因组新一代测序的临床特征及价值

Polish journal of microbiology Pub Date : 2025-06-18 eCollection Date: 2025-06-01 DOI:10.33073/pjm-2025-016
Xinyan Yu, Jiuchao Liang, Rui Yang, Wei Gai, Yafeng Zheng
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引用次数: 0

摘要

肺炎是儿童死亡的主要原因。虽然新一代宏基因组测序(mNGS)有可能检测到肺炎患者体内的所有微生物,但这些微生物与患者临床特征之间的关系仍有待建立。本研究纳入了2021年7月至2022年11月在北京儿童医院黑龙江医院诊断为重症肺炎并接受气管抽吸(TA) mNGS进行病原体检测的55名儿童。分析患儿的临床特点、病原菌分布及微生物组特征。结果:混合感染发生率较高(80%,44/55),以细菌-病毒感染最为常见。肺炎链球菌、肺炎支原体(MP)、白色念珠菌和呼吸道合胞病毒(RSV)是该队列中最常见的病原体。此外,呼吸道合胞病毒和肺炎链球菌是12个月以下儿童(婴儿)中最常见的病原体,而MP和流感嗜血杆菌在12至144个月的儿童中更常见。在年龄较大的儿童TA中观察到微生物群的丰富度和多样性增加。线性判别分析(LDA)效应大小(LEfSe)分析发现,RSV和链球菌是与婴儿相关的特定菌种。相比之下,人类bocaparvovirus 1和Prevotella histicola在年龄较大的儿童中显著富集。此外,前20个最丰富的物种与中性粒细胞计数和c反应蛋白呈相关性。本研究强调了利用mNGS更好地了解小儿重症肺炎患者的临床特征和微生物多样性的意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Features and Value of Tracheal Aspirate Metagenomic Next-Generation Sequencing for Severe Pneumonia in Children in Pediatric Intensive Care Unit.

Pneumonia is a leading cause of mortality in children. While metagenomic next-generation sequencing (mNGS) has the potential to detect all the microorganisms in pneumonia patients, the relationship between these microorganisms and the patients' clinical characteristics remains to be established. Fifty-five children, diagnosed with severe pneumonia and undergoing tracheal aspirate (TA) mNGS for pathogen detection at The Heilongjiang Hospital of Beijing Children's Hospital between July 2021 and November 2022, were included in this study. The clinical characteristics, pathogen distribution, and microbiome features of these children were analyzed. Results showed that the rate of mixed infections was notably high (80%, 44/55), with bacterial-viral infections being the most common. Streptococcus pneumoniae, Mycoplasma pneumoniae (MP), Candida albicans, and Respiratory syncytial virus (RSV) were the most common pathogens in this cohort. Furthermore, RSV and S. pneumoniae were the most prevalent pathogens in children younger than 12 months (infants), while MP and Haemophilus influenzae were more commonly identified in children between 12 and 144 months. Increased richness and diversity of the microbiota were observed in the TA of the older children. Linear discriminant analysis (LDA) effect size (LEfSe) analysis identified that RSV and Streptococcus mitis were the specific species associated with infants. In contrast, Human bocaparvovirus 1 and Prevotella histicola were significantly enriched in the older children. In addition, the top 20 most abundant species exhibited correlations with neutrophil count and C-reactive protein. This study emphasizes the significance of employing mNGS to understand better the clinical characteristics and microbial diversity in pediatric patients with severe pneumonia.

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