摘要
目的 探讨肺泡灌洗液病原微生物宏基因组二代测序(mNGS)对儿童迁延性肺炎病因的诊断价值.方法 选取2019年6月至2021年6月期间诊断为儿童迁延性肺炎的46例患者进行电子支气管镜检查,将肺泡灌洗液进行mNGS检测,同时进行传统病原学培养,比较mNGS与传统检测方法对病原菌的检出结果,以评价mNGS对于迁延性肺炎病因的诊断价值.结果 纳入研究的46例迁延性肺炎的患儿中,通过mNGS检测出病原体41例,阳性率为89.1%,而传统病原学培养检出病原体为21例,阳性率为45.7%;两种检测方法比较,发现mNGS检测技术儿童迁延性肺炎病因的病原学诊断中的灵敏性为100%,准确性为56.52%;对检查前已经使用抗菌药物治疗的40例病例中,mNGS检测方法有较高的阳性检出率,与传统病原学检测方法相比,差异有统计学意义(P<0.05).结论 肺泡灌洗液mNGS检测的结果受抗菌药物暴露的影响小,且在儿童迁延性肺炎病原检测较为敏感、诊断较为准确,可提高儿童迁延性肺炎的病原学诊断率,值得在临床推广.
Objective To explore the diagnostic value of Metagenomic next generation sequencing(mNGS)from alveolar lavage fluid in children with prolonged pneumonia.Methods Electronic bronchoscopy was performed on 46 patients diagnosed with prolonged pneumonia in children between June 2019 and December 2020,the alveolar lavage fluid was treated by microbial mNGS,and the traditional pathogenic culure was carried out at the same time.The detection results of pathogens by mNGS and traditional detection methods were compared to evaluate the diagnostic value of mNGS in the etiology of persistent pneumonia.Results Among the 46 children with persistent pneumonia selected for the study,41 cases of pathogens were detected by mNGS,with a positive rate of 89.1%,while 21 cases of pathogens were detected by traditional pathogen culture,with a positive rate of 45.7%.Comparison of the detection methods showed that the sensitivity of the mNGS detection technology in the etiological diagnosis of the etiology of children with persistent pneumonia was 100%,and the accuracy was 56.52%.Among the 40 cases that had been treated with antibacterial drugs before the examination,mNGS detection method had higher positive detection rate,compared with traditional pathogenic examination methods,the differences were statistically significant(P<0.05).Conclusion The results of mNGS detection in alveolar lavage fluid are les affected by exposure to antibacterial drugs,and the detection of pathogens in children with persistent pneumonia is more sensitive and the diagnosis is more accurate.It can improve the pathogenic diagnosis rate of children with persistent pneumonia and is worthy of clinical promotion.
出处
《浙江临床医学》
2022年第8期1193-1195,共3页
Zhejiang Clinical Medical Journal
基金
广西壮族自治区卫健委自筹经费科研课题(Z20200228)
柳州市科技计划项目(2021CB0126)。
