中国当代儿科杂志2023，Vol.25Issue(12)：1253-1258,6.DOI:10.7499/j.issn.1008-8830.2307106
支气管肺泡灌洗液宏基因组二代测序在儿童难治性肺炎诊治中的应用
Application of metagenomic next-generation sequencing of bronchoalveolar lavage fluid in the diagnosis and treatment of refractory pneumonia in children
摘要
Abstract
Objective To investigate the clinical application of metagenomic next-generation sequencing(mNGS)of bronchoalveolar lavage fluid(BALF)in the etiological diagnosis and treatment of refractory pneumonia(RTP)in children.Methods A retrospective analysis was performed on 160 children with RTP who were admitted to the Department of Pediatric Internal Medicine,Maternal and Child Health Hospital of Inner Mongolia Autonomous Region,from January 2020 to March 2023.According to whether mNGS was performed,they were divided into two groups:mNGS(n=80)and traditional testing(n=80).All children received the tests of inflammatory markers and pathogen tests after admission.Traditional pathogenicity tests included microbial culture(sputum specimen collected by suction tube),nucleic acid detection of respiratory pathogens,and serological test(mycoplasma,tuberculosis,and fungi).For the mNGS group,BALF specimens were collected after bronchoscopy and were sent to the laboratory for mNGS and microbial culture.The two groups were analyzed and compared in terms of the detection of pathogens and treatment.Results Compared with the traditional testing group,the mNGS group had a significantly higher detection rate of pathogens(92%vs 58%,P<0.05),with more types of pathogens and a higher diagnostic rate of mixed infections.Compared with the traditional testing group,the mNGS group had a significantly higher treatment response rate and a significantly lower incidence rate of complications during hospitalization(P<0.05).Treatment was adjusted for 68 children in the mNGS group according to the results of mNGS,with a treatment response rate of 96%(65/68)after adjustment.Conclusions Compared with traditional pathogen tests,BALF mNGS can significantly improve the detection rate of pathogens and find some rare pathogens.In clinical practice,when encountering bottlenecks during the diagnosis and treatment of children with RTP,it is advisable to promptly perform the mNGS to identify the pathogens.关键词
难治性肺炎/支气管肺泡灌洗液/宏基因组二代测序/儿童Key words
Refractory pneumonia/Bronchoalveolar lavage fluid/Metagenomic next-generation sequencing/Child引用本文复制引用
冯荣光,周丽岩,窦蕊,周雪原,王莉荣,韩丽红,王育民..支气管肺泡灌洗液宏基因组二代测序在儿童难治性肺炎诊治中的应用[J].中国当代儿科杂志,2023,25(12):1253-1258,6.基金项目
内蒙古自治区卫生科技计划项目(202201132). （202201132）
