肉芽肿性小叶性乳腺炎的病原体检测和抗生素使用:mNGS和培养的比较。

IF 4.6 2区 医学 Q2 IMMUNOLOGY
Frontiers in Cellular and Infection Microbiology Pub Date : 2025-06-03 eCollection Date: 2025-01-01 DOI:10.3389/fcimb.2025.1570776
Xu Mu, Hongmin Luo, Hanhua Li, Shenghua Chen, Yuyang Han, Lin Zhang, Wei Liu, Weilong Qiao, Shaoyi Zheng, Zhifeng Huang
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引用次数: 0

摘要

目的:评价肉芽肿性小叶乳腺炎(GLM)患者的临床微生物特征,并比较各种检测方法,以确定最有效的病原体检测方法,以提高临床诊断和治疗水平。方法:回顾性分析84例GLM患者的资料,评估这些患者的病原微生物组成,并比较不同采样方法和检测技术的有效性。结果:经鉴定,GLM患者的主要微生物为克氏棒状杆菌(C. kroppenstedtii)。皮肤拭子的阳性率较低(10%),但脓液(40%)和组织样本(37%)的阳性率相似。抗生素治疗后,宏基因组新一代测序(mNGS)的病原菌检出率(54.55%)高于培养法(27.27%)。在致病性感染的GLM病例中,尽管mNGS的敏感性(75.0%)高于培养试验(50.0%),但两种方法的特异性均为100.0%。但mNGS获得结果的时间(1.2±0.41 d)明显短于细菌培养(5.5±0.64 d) (P < 0.05)。结论:我们的研究结果表明脓液是GLM患者微生物证据收集最合适的样本类型。与培养相比,mNGS在区分感染性和非感染性病例方面表现出优越的性能,抗生素干扰减少,周转时间更快,准确性更高。根据我们的单中心经验,经验性头孢菌素治疗可能适合这些患者。此外,手术干预仍然是快速和完全解决的最有效方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pathogen detection and antibiotic use in granulomatous lobular mastitis: a comparison of mNGS and culture.

Objective: This study aimed to evaluate the clinical microbial profile of patients with granulomatous lobular mastitis (GLM) and compare various detection methods to identify the most effective approach for pathogen detection, which could help enhance clinical diagnosis and treatment.

Methods: We retrospectively analyzed data from 84 patients diagnosed with GLM, assessed the composition of pathogenic microorganisms in these patients, and compared the effectiveness of different sampling methods and detection techniques.

Results: Corynebacterium kroppenstedtii (C. kroppenstedtii) was identified as the predominant microorganism among GLM patients. The positivity rate was low in skin swabs (10%) but similar in pus (40%) and tissue samples (37%). After antibiotic treatment, the pathogen detection rate of metagenomic next-generation sequencing (mNGS) (54.55%) was found to be higher than that of culture-based methods (27.27%). Among the GLM cases with pathogenic infection, although mNGS demonstrated higher sensitivity (75.0%) than culture tests (50.0%), both methods exhibited 100.0% specificity. However, the time for obtaining results with mNGS was significantly shorter (1.2 ± 0.41 days) compared to bacterial culture (5.5 ± 0.64 days) (P < 0.05).

Conclusions: Our findings indicate that pus was the most suitable sample type for microbial evidence collection in patients with GLM. mNGS demonstrated superior performance compared to culture in distinguishing infectious from non-infectious cases, with reduced antibiotic interference, faster turnaround time, and higher accuracy. Based on our single-center experience, empirical cephalosporin treatment may be appropriate for these patients. Additionally, surgical intervention remains the most efficient approach for rapid and complete resolution.

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来源期刊
CiteScore
7.90
自引率
7.00%
发文量
1817
审稿时长
14 weeks
期刊介绍: Frontiers in Cellular and Infection Microbiology is a leading specialty journal, publishing rigorously peer-reviewed research across all pathogenic microorganisms and their interaction with their hosts. Chief Editor Yousef Abu Kwaik, University of Louisville is supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Cellular and Infection Microbiology includes research on bacteria, fungi, parasites, viruses, endosymbionts, prions and all microbial pathogens as well as the microbiota and its effect on health and disease in various hosts. The research approaches include molecular microbiology, cellular microbiology, gene regulation, proteomics, signal transduction, pathogenic evolution, genomics, structural biology, and virulence factors as well as model hosts. Areas of research to counteract infectious agents by the host include the host innate and adaptive immune responses as well as metabolic restrictions to various pathogenic microorganisms, vaccine design and development against various pathogenic microorganisms, and the mechanisms of antibiotic resistance and its countermeasures.
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