PDF(Pubmed)
Abstract：
UNASSIGNED: Targeted next-generation sequencing (tNGS) has emerged as a rapid diagnostic technology for identifying a wide spectrum of pathogens responsible for pulmonary infections.
UNASSIGNED: Sputum samples were collected from patients unable or unwilling to undergo bronchoalveolar lavage. These samples underwent tNGS analysis to diagnose pulmonary infections. Retrospective analysis was performed on clinical data, and the clinical efficacy of tNGS was compared to conventional microbiological tests (CMTs).
UNASSIGNED: This study included 209 pediatric and adult patients with confirmed pulmonary infections. tNGS detected 45 potential pathogens, whereas CMTs identified 23 pathogens. The overall microbial detection rate significantly differed between tNGS and CMTs (96.7% vs. 36.8%, p < 0.001). Among the 76 patients with concordant positive results from tNGS and CMTs, 86.8% (66/76) exhibited full or partial agreement. For highly pathogenic and rare/noncolonized microorganisms, tNGS, combined with comprehensive clinical review, directly guided pathogenic diagnosis and antibiotic treatment in 21 patients. This included infections caused by Mycobacterium tuberculosis complex, certain atypical pathogens, Aspergillus, and nontuberculous Mycobacteria. Among the enrolled population, 38.8% (81/209) of patients adjusted their treatment based on tNGS results. Furthermore, tNGS findings unveiled age-specific heterogeneity in pathogen distribution between children and adults.
UNASSIGNED: CMTs often fall short in meeting the diagnostic needs of pulmonary infections. This study highlights how tNGS of sputum samples from patients who cannot or will not undergo bronchoalveolar lavage yield valuable insights into potential pathogens, thereby enhancing the diagnosis of pulmonary infections in specific cases.
UNASSIGNED: Sputum samples were collected from patients unable or unwilling to undergo bronchoalveolar lavage. These samples underwent tNGS analysis to diagnose pulmonary infections. Retrospective analysis was performed on clinical data, and the clinical efficacy of tNGS was compared to conventional microbiological tests (CMTs).
UNASSIGNED: This study included 209 pediatric and adult patients with confirmed pulmonary infections. tNGS detected 45 potential pathogens, whereas CMTs identified 23 pathogens. The overall microbial detection rate significantly differed between tNGS and CMTs (96.7% vs. 36.8%, p < 0.001). Among the 76 patients with concordant positive results from tNGS and CMTs, 86.8% (66/76) exhibited full or partial agreement. For highly pathogenic and rare/noncolonized microorganisms, tNGS, combined with comprehensive clinical review, directly guided pathogenic diagnosis and antibiotic treatment in 21 patients. This included infections caused by Mycobacterium tuberculosis complex, certain atypical pathogens, Aspergillus, and nontuberculous Mycobacteria. Among the enrolled population, 38.8% (81/209) of patients adjusted their treatment based on tNGS results. Furthermore, tNGS findings unveiled age-specific heterogeneity in pathogen distribution between children and adults.
UNASSIGNED: CMTs often fall short in meeting the diagnostic needs of pulmonary infections. This study highlights how tNGS of sputum samples from patients who cannot or will not undergo bronchoalveolar lavage yield valuable insights into potential pathogens, thereby enhancing the diagnosis of pulmonary infections in specific cases.
摘要：
■靶向下一代测序（tNGS）已成为一种快速诊断技术，用于识别导致肺部感染的多种病原体。
■从不能或不愿意进行支气管肺泡灌洗的患者收集痰样本。对这些样本进行tNGS分析以诊断肺部感染。对临床资料进行回顾性分析，并将tNGS的临床疗效与常规微生物学试验(CMTs)进行比较。
■这项研究包括209名确诊为肺部感染的儿童和成人患者。tNGS检测到45种潜在病原体，而CMT鉴定出23种病原体。tNGS和CMT之间的总体微生物检出率显着不同(96.7%与36.8%,p<0.001)。在tNGS和CMT结果一致阳性的76例患者中，86.8％（66/76）表现出完全或部分同意。对于高致病性和稀有/非定殖微生物，tNGS,结合全面的临床审查，21例直接指导病原学诊断和抗生素治疗。这包括结核分枝杆菌复合体引起的感染，某些非典型病原体，曲霉菌,和非结核分枝杆菌.在登记人口中，38.8%(81/209)的患者根据tNGS结果调整治疗。此外，tNGS研究结果揭示了儿童和成人之间病原体分布的年龄特异性异质性。
■CMT通常无法满足肺部感染的诊断需求。这项研究强调了无法或不会接受支气管肺泡灌洗的患者的痰液样本的tNGS如何对潜在病原体产生有价值的见解。从而增强特定病例中肺部感染的诊断。
■从不能或不愿意进行支气管肺泡灌洗的患者收集痰样本。对这些样本进行tNGS分析以诊断肺部感染。对临床资料进行回顾性分析，并将tNGS的临床疗效与常规微生物学试验(CMTs)进行比较。
■这项研究包括209名确诊为肺部感染的儿童和成人患者。tNGS检测到45种潜在病原体，而CMT鉴定出23种病原体。tNGS和CMT之间的总体微生物检出率显着不同(96.7%与36.8%,p<0.001)。在tNGS和CMT结果一致阳性的76例患者中，86.8％（66/76）表现出完全或部分同意。对于高致病性和稀有/非定殖微生物，tNGS,结合全面的临床审查，21例直接指导病原学诊断和抗生素治疗。这包括结核分枝杆菌复合体引起的感染，某些非典型病原体，曲霉菌,和非结核分枝杆菌.在登记人口中，38.8%(81/209)的患者根据tNGS结果调整治疗。此外，tNGS研究结果揭示了儿童和成人之间病原体分布的年龄特异性异质性。
■CMT通常无法满足肺部感染的诊断需求。这项研究强调了无法或不会接受支气管肺泡灌洗的患者的痰液样本的tNGS如何对潜在病原体产生有价值的见解。从而增强特定病例中肺部感染的诊断。
