眼科学报2025，Vol.40Issue(12)：1016-1023,8.DOI:10.12419/25033109
粤东地区外伤性眼内炎病原谱特征与分子诊断价值:基于培养和高通量测序的对比分析
Pathogen spectrum characteristics and molecular diagnostic significance in traumatic endophthalmitis:a comparative analysis based on culture and next-generation sequencing
摘要
Abstract
Objective:This study aimed to conduct a systematic analysis of the pathogen distribution and antimicrobial resistance patterns in posttraumatic endophthalmitis(PTE)in Eastern Guangdong,China.Additionally,it aimed to evaluate the diagnostic efficacy of next-generation sequencing(NGS)in comparison with conventional microbial culture,thereby providing evidence-based insights to optimize the management of PTE.Methods:Clinical data of 31 PTE patients admitted to a tertiary ophthalmic center between January 2019 and January 2025 were retrospectively reviewed.All patients underwent microbiological testing,including both culture and NGS,and received standardized treatment with follow-up.The pathogen detection rates and concordance between the two methods were compared using the chi-square test.Results:A total of 36 pathogens were identified,with bacteria accounting for 88.9%(32/36).Gram-positive cocci(52.8%)were the most prevalent,primarily consisting of Staphylococcus epidermidis,Streptococcus pneumoniae,and Staphylococcus aureus.Gram-negative bacteria(36.1%)were mainly Citrobacter koseri.Fungi made up 11.1%(4/36)of the identified pathogens,primarily Aspergillus species.NGS demonstrated a significantly higher overall positivity(80.6%)compared to culture(16.1%)(P<0.05).Moreover,NGS detected viruses(such as Epstein-Barr virus)and identified 29.0%of polymicrobial infections.Antimicrobial resistance analysis revealed frequent resistance to penicillin G,trimethoprim-sulfamethoxazole,and oxacillin.NGS also identified two pathogens carrying resistance genes(mecA,blaCTX-M).Conclusions:NGS significantly enhances the sensitivity and specificity of pathogen detection in PTE,particularly for identifying polymicrobial infections,fungi,and fastidious organisms.Combining conventional culture with NGS is recommended to guide targeted antimicrobial therapy.These findings highlight the importance of regional pathogen surveillance and call for future large-scale,multi-omics studies to refine individualized protocols for PTE.关键词
外伤性眼内炎/微生物培养/高通量测序/致病微生物Key words
posttraumatic endophthalmitis/microbial culture/next-generation sequencing/pathogenic microorganisms分类
医药卫生引用本文复制引用
史庭坤,翁沛鑫,夏红和,金创,陈浩宇,黄育强..粤东地区外伤性眼内炎病原谱特征与分子诊断价值:基于培养和高通量测序的对比分析[J].眼科学报,2025,40(12):1016-1023,8.基金项目
广东省医学科研基金(B2024255).This study was supported in part by Guangdong Province Medical Research Grant(B2024255). （B2024255）
