摘要
目的:分析临床药师基于宏基因组测序技术协助临床对重症感染性疾病患者临床用药治疗的指导作用。方法:选取医院3例重症感染性疾病(颅内脓肿2例、肾移植术后重症肺炎1例)患者病历资料,在常规病原学培养检测报告受限的情况下,临床药师参与会诊后建议采用宏基因组测序技术(metagenomic next-generation sequencing,mNGS)明确其感染病原菌种,分析其抗感染治疗的药学监护过程。结果:宏基因组测序与应用明确了2例脑脓肿患者术中脓液标本、1例肾移植术后重症肺炎肺泡灌洗液标本中感染致病菌,临床药师结合临床特点及药学知识,提出个体化的药学建议,3例感染患者均得到有效救治。结论:宏基因组测序技术的应用对复杂感染性疾病提供新的技术支持,给临床药师会诊提供更多证据。
Objective: To analyze the guiding effect of clinical pharmacists on clinical drug therapy of patients with severe infectious diseases assisted by metagenomic next-generation sequencing(mNGS) technique. Methods: The medical records of 3 patients with severe infectious diseases(2 cases of intracranial abscess and 1 case of severe pneumonia after kidney transplantation) in the hospital were selected. In the case that the routine etiological culture and test report was limited, the clinical pharmacist was recommended to adopt metagenomic sequencing technique after consultation. mNGS to identify the pathogen of infection and analyze the pharmaceutical care process of anti-infection medication. Results: Metagenomic sequencing and application identified the infection of pathogenic bacteria in the intraoperative pus samples of 2 patients with brain abscess and in the alveolar lavage fluid samples of 1 patient with severe pneumonia after kidney transplantation. The clinical pharmacists combined with clinical characteristics and pharmaceutical knowledge, put forward individualized pharmaceutical suggestions, and the 3 infected patients were effectively treated.Conclusion: The application of metagenomic sequencing technique provides new technical support for complex infectious diseases and provides more evidence for clinical pharmacist consultation.
作者
张建东
韩晶晶
王红宇
ZHANG Jian-dong;HAN Jing-jing;WANG Hong-yu(The People's Hospital of Zhengzhou,Zhengzhou 450003,China)
出处
《抗感染药学》
2021年第7期962-965,1046,共5页
Anti-infection Pharmacy
基金
河南省医学科技攻关计划项目(编号:2018020828)。
关键词
宏基因组测序
临床药师
复杂感染性疾病
颅内脓肿
重症肺炎
metagenomic sequencing
clinical pharmacists
complex infectious diseases
intracranial abscess
severe pneumonia
