中国真菌学杂志2025，Vol.20Issue(6)：581-585,5.DOI:10.3969/j.issn.1673-3827.2025.06.004
靶向高通量测序对非HIV感染患者耶氏肺孢子菌肺炎的诊断价值
The diagnostic value of targeted next-generation sequencing in diagnosing Pneumocystis jirovecii pneumonia in non-HIV-infected patients
摘要
Abstract
Objective To evaluate the diagnostic value of targeted next-generation sequencing(tNGS)in Pneumocystis jirovecii pneumonia(PJP)in non-HIV-infected patients.Methods Clinical data were retrospectively analyzed for non-HIV-infected PJP patients and non-HIV/non-PJP pneumonia patients who underwent tNGS testing in No.909 Hospital from January 2022 to December 2024.Using clinical composite diagnosis as the gold standard,the diagnostic performance of tNGS,polymerase chain reaction(PCR),and serum(1,3)-β-D-glucan(BDG)assays for detecting Pneumocystis.jirovecii and co-pathogens in bronchoalveolar lavage fluid(BALF)was evaluated.Results A total of 115 non-HIV-infected pneumonia patients were included,including 54 PJP cases.Compared to the gold standard,tNGS demonstrated 100%sensitivity,specificity,negative predictive value,positive predictive value,and accuracy for PJP diagnosis,surpassing the corresponding values from PCR and serum BDG.Among the 54 PJP patients,tNGS identified 8 cases(14.81%)of simple Pneumocystis jirovecii infection and 46 cases(85.19%)of mixed infections.The detection rate of tNGS for mixed infection was significantly higher than conventional pathogen testing(85.19%vs.66.67%,P=0.024).In BALF samples,tNGS detected a total of 147 pathogen.Apart from Pneumocystis jirovecii,the most common pathogens were Epstein-Barr virus(13 cases),Candida albicans(11 cases),Human herpesvirus-5(9 cases),and Acinetobacter baumannii(8 cases).Conclusion tNGS provides accurate diagnosis of PJP in non-HIV-infected patients and offers advantages in identifying mixed infections.关键词
靶向高通量测序/耶氏肺孢子菌肺炎/聚合酶链反应/非HIV感染Key words
targeted next-generation sequencing/Pneumocystis jirovecii pneumonia/polymerase chain reaction/non-HIV infection引用本文复制引用
杨海洋,张才金,赖铭鸿,林炳棋..靶向高通量测序对非HIV感染患者耶氏肺孢子菌肺炎的诊断价值[J].中国真菌学杂志,2025,20(6):581-585,5.基金项目
福建省自然科学基金联合资金新上项目(2023J011841) （2023J011841）
