摘要
虫媒传播疾病是危及生命的严重传染性疾病,快速且精准病原学诊断是临床及时有效治疗并降低病死率、减少后遗症的前提。虫媒病实验室诊断以靶向性的血清学检测和聚合酶链反应为主,对少见虫媒病原体检出困难。目前,宏基因组二代测序技术(mNGS)已从科研走向临床应用。mNGS检测感染标本中全部生物的核酸序列并进行生物信息学分析,在少见病原体诊断和溯源方面具有显著优势。但同时mNGS也面临着整个操作流程中可能引入的背景微生物污染、数据库限制造成的错误结果、临床治疗亟需的病原体耐药性和宿主免疫状态等信息的挑战。该文主要就mNGS技术、其在虫媒病原体诊断应用及其所面临的挑战与难题等方面进行系统论述。随着mNGS在检测流程、检测结果分析和解读等方面不断优化,将为临床感染病病原学诊断带来新的发展与革新。
Insect-borne diseases are serious life-threatening infectious diseases.Rapid and accurate etiological diagnosis are the premise of timely and effective clinical treatments,reducing mortality and sequelae.Laboratory diagnoses of insect-borne diseases mainly focus on targeted serological detection and polymerase chain reaction,which is difficult to detect rare insect borne pathogens.At present,the metagenomic next-generation sequencing(mNGS)technology has moved from scientific research into clinical application.The detection of nucleic acid sequences of all organisms in infected samples by mNGS exhibited significant advantages in the diagnosis and traceability of rare pathogens.But at the same time,mNGS is also suffered with challenges such as background microbial interference,false results caused by database restrictions,pathogen resistance and host immune status information that are urgently needed for clinical treatments.This article systematically summarized applications of mNGS in the diagnosis of insect-borne pathogens and the challenges and difficulties it faces.With the continuous optimization of mNGS in the detection,it will bring new development and innovation to the etiology diagnosis of clinical infectious diseases.
作者
王曼媛
魏慕筠
李敏
Wang Manyuan;Wei Muyun;Li Min(Department of Laboratory Medicine,Ren Ji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2023年第2期119-126,共8页
Chinese Journal of Laboratory Medicine
关键词
虫媒病毒感染
宏基因组
二代测序
核酸
生物信息学
Arbovirus infections
Metagenomics
Next-generation sequencing
Nucleic acids
Bioinformatics
