摘要
目的基于宏基因组学第二代测序(mNGS)技术,分析烧伤脓毒症患者感染病原体的特征。方法该研究为回顾性观察性研究。2021年7月—2023年12月,郑州市第一人民医院烧伤科收治109例符合入选标准的烧伤脓毒症患者,其中男68例,年龄57~92岁;女41例,年龄48~83岁。采集患者住院期间的血液、支气管肺泡灌洗液、脑脊液、痰液或其他液体标本,分别进行微生物培养(86例患者)和mNGS技术检测(109例患者)。统计采用mNGS技术检测的送检标本类型及检出病原体的情况,同时将患者分为入住重症监护病房(ICU)的ICU组(78例)和未入住ICU的非ICU组(31例),并对2组患者感染的病原体进行分析。另对同时进行mNGS技术检测和微生物培养检测的86例患者标本的病原体检出情况进行分析。结果采用mNGS技术检测的109份标本中,血液标本42份、支气管肺泡灌洗液标本17份、痰液标本4份、脑脊液标本6份、脓液标本16份、组织液标本24份;共检测出39种病原体,其中细菌13种、真菌12种、病毒10种、寄生虫2种、支原体2种;检出病原体的总体阳性率为88.99%(97/109)。检出率排前3位的革兰阴性菌依次是肺炎克雷伯菌、鲍曼不动杆菌、假单胞菌,排前3位的革兰阳性菌依次是肺炎链球菌、金黄色葡萄球菌、粪肠球菌;检出率排前3位的病毒依次是人类疱疹病毒、巨细胞病毒、细环病毒;检出率排前3位的真菌依次是烟曲霉菌、白色念珠菌、黄曲霉菌。27例患者感染1种病原体,45例患者感染2种病原体,25例患者感染≥3种病原体。与非ICU组相比,ICU组患者检出的肺炎克雷伯菌、鲍曼不动杆菌、假单胞菌、肺炎链球菌、烟曲霉菌、巨细胞病毒的占比均明显升高(χ^(2)值分别为8.62、7.93、3.93、5.48、4.28、5.58,P<0.05)。mNGS技术和微生物培养法检出的病原体中,最常见细菌的是肺炎克雷伯菌和鲍曼不动杆菌,最常见的真菌是曲霉菌属�
Objective To analyze the characteristics of infectious pathogens in burn patients with sepsis based on metagenomic next-generation sequencing(mNGS)technology.MethodsThis study was a retrospective observational study.From July 2021 to December 2023,109 burn patients with sepsis who met the inclusion criteria were admitted to the Department of Burns of the First People's Hospital of Zhengzhou,including 68 males aged 57 to 92 years and 41 females aged 48 to 83 years.Blood,bronchoalveolar lavage fluid,cerebrospinal fluid,sputum,or other fluid specimens were collected from the patients during their hospital stay for microbiological culture(86 patients)and mNGS technology detection(109 patients).The types of specimens and pathogens detected by mNGS technology were counted.Patients were divided into intensive care unit(ICU)group(78 cases)who were admitted to the ICU and non-ICU group(31 cases)who were not admitted to the ICU,and the pathogens for infection in the two groups of patients were analyzed.In addition,the detection of pathogens in the specimens of 86 patients who underwent both mNGS technology detection and microbiological culture detection was analyzed.ResultsAmong the 109 specimens detected by mNGS technology,there were 42 blood specimens,17 bronchoalveolar lavage fluid specimens,4 sputum specimens,6 cerebrospinal fluid specimens,16 pus specimens,and 24 tissue fluid specimens;a total of 39 pathogens were detected,including 13 bacteria,12 fungi,10 viruses,2 parasites,and 2 mycoplasmas.The overall positive rate of pathogen detection was 88.99%(97/109).Ranked by the detection rate,the top three Gram-negative bacteria were Klebsiella pneumoniae,Acinetobacter baumannii,and Pseudomonas spp,the top three Gram-positive bacteria were Streptococcus pneumoniae,Staphylococcus aureus,and Enterococcus faecalis;the top three viruses were human herpesvirus,cytomegalovirus,and circovirus;the top three fungi were Aspergillus fumigatus,Candida albicans,and Aspergillus flavus.Twenty-seven patients were infected with one pathoge
作者
史继静
赵靓
李晓亮
张群
夏成德
马超
Shi Jijing;Zhao Liang;Li Xiaoliang;Zhang Qun;Xia Chengde;Ma Chao(Central Laboratory,the First People's Hospital of Zhengzhou,Zhengzhou 450004,China;Department of Burns,the First People's Hospital of Zhengzhou,Zhengzhou 450004,China;Department of Plastic Surgery,the First People's Hospital of Zhengzhou,Zhengzhou 450004,China)
出处
《中华烧伤与创面修复杂志》
CAS
CSCD
北大核心
2024年第10期940-947,共8页
Chinese Journal of Burns And Wounds
基金
河南省中青年卫生健康科技创新优秀青年人才培养项目(YXKC2020060)
河南省医学科技攻关计划项目(LHGJ20230754)。
