摘要
目的应用宏基因组测序分析支气管扩张症合并肺部感染患者支气管肺泡灌洗液病原微生物分布情况。方法支气管扩张症合并肺部感染患者43例,均行纤维支气管镜检查获取支气管肺泡灌洗液标本,进行宏基因组测序,分析病原微生物分布情况及革兰染色细菌分型与临床症状的关系。结果43例患者中存在多菌感染33例(76.74%)。43例患者共检出184株病原微生物,其中细菌149株(80.98%)(革兰阴性菌107株,革兰阳性菌42株),真菌15株(8.15%),病毒8株(4.35%),分枝杆菌10株(5.43%),其他2株(1.09%)。革兰阴性菌以铜绿假单胞菌、副流感嗜血杆菌为主,革兰阳性菌以肺炎链球菌、假肺炎链球菌、金黄色葡萄球菌为主。革兰阳性菌感染者呼吸困难、咯血、发热发生率(32.00%、28.00%、36.00%)与革兰阴性菌感染者(20.00%、25.71%、37.14%)比较差异均无统计学意义(P>0.05)。结论支气管扩张症合并肺部感染患者支气管肺泡灌洗液病原微生物以革兰阴性菌为主,宏基因组测序可检出多菌感染,有助于临床合理选用抗菌药物。
Objective To analyze the distribution of pathogenic bacteria by metagenomic next-generation sequencing(mNGS)in bronchoalveolar lavage fluid(BALF)of patients with pulmonary infection secondary to bronchiectasis,and to investigate the value of mNGS to the diagnosis of pathogenic bacteria.Methods Forty-three patients with pulmonary infection secondary to bronchiectasis received electronic bronchoscopy to collect BALF samples for mNGS.The distribution of pathogenic bacteria,and the relationship between Gram-positive bacteria infection type and clinical symptoms were analyzed.Results Among these 43 patients,33 patients(76.74%)were detected multi-bacterial infection.A total of 184 strains of pathogenic bacteria were detected in 43 patients,including 149 strains(80.98%)of bacteria(107 Gram-negative bacteria and 42 Gram-positive bacteria),15 strains of fungi(8.15%),8 strains of virus(4.35%),10 strains of mycobacteria(5.43%)and 2 other strains(1.09%).The Gram-negative bacteria mainly included Pseudomonas aeruginosa and Haemophilus parainfluenzae,and the Gram-positive bacteria mainly included Streptococcus pneumoniae,Streptococcus pneumoniae and Staphylococcus aureus.There were no significant differences in the incidences of dyspnea,hemoptysis and fever between patients with Gram-negative bacteria infection(32.00%,28.00%,36.00%)and Gram-positive bacteria infection(20.00%,25.71%,37.14%)(P>0.05).Conclusions Gram-negative bacteria infection is the main type of pathogenic bacteria infections in BALF of patients with pulmonary infection secondary to bronchiectasis.mNGS can detect multi-bacterial infection and contributes to the rational choice of antibacterial agents.
作者
任靖宜
苏莹莹
康小文
REN Jing-yi;SU Ying-ying;KANG Xiao-wen(Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150081,China)
出处
《中华实用诊断与治疗杂志》
2022年第8期849-851,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
吴阶平医学基金(320.6750.2020-5-12)。
关键词
支气管扩张症
肺部感染
宏基因组测序
支气管肺泡灌洗液
病原微生物
bronchiectasis
pulmonary infection
metagenomic next-generation sequencing
bronchoalveolar lavage fluid
pathogenic bacteria
