■对于先天性心脏手术(CHS)后感染呼吸道病毒的儿童,及时准确的病原体诊断可能具有挑战性。这通常导致药物使用欠佳和治疗延迟。宏基因组学下一代测序(mNGS)是一种快速、高效,和无偏获得微生物核酸序列的方法。这项技术有望成为一种全面的诊断工具,特别是对于传统方法检测不到的病原体。然而,mNGS在先天性心脏病感染中的疗效仍不确定.本研究旨在探讨mNGS对CHS后呼吸道病毒感染的诊断价值。
我们对CHS后发生呼吸道感染并在2021年7月至2022年12月期间入住我们心脏中心的患者进行了回顾性分析。根据所使用的诊断方法将患者分为以下两组:(I)mNGS组(包括62名患者);和(II)常规微生物测试(CMT)组(包括70名患者)。测试来自这些患者的支气管肺泡灌洗液(BALF)样品以鉴定病原体。
■mNGS组的病毒感染和混合病毒感染的检出率均明显高于CMT组(56.45%vs.17.14%,P<0.001,80.00%vs.16.67%,分别为P<0.001)。在mNGS组中,19.35%的患者接受抗病毒治疗,61.29%接受了抗感染方案调整。相反,在CMT组中,只有4.29%接受抗病毒治疗,28.57%接受了抗感染方案调整.mNGS组呼吸道症状改善的患者比例高于CMT组(74.19%vs.44.29%,P=0.001)。此外,与CMT组相比,mNGS组的机械通气时间较短,在心脏重症监护病房的住院时间较短(P=0.012).
■将mNGS用于BALF可增强CHS后呼吸道病毒感染和共存病毒感染的检测。这有助于更精确的治疗策略,并可能导致改善患者预后。
UNASSIGNED: Timely and accurate pathogen diagnosis can be challenging in children who contract a respiratory virus following congenital heart surgery (CHS). This often results in suboptimal drug use and treatment delays. Metagenomics next-generation sequencing (mNGS) is a swift, efficient, and unbiased method for obtaining microbial nucleic acid sequences. This technology holds promise as a comprehensive diagnostic tool, especially for pathogens undetectable by traditional methods. However, the efficacy of mNGS in the context of congenital heart disease infections remains uncertain. This study aimed to explore the diagnostic value of mNGS for respiratory virus infections post-CHS.
UNASSIGNED: We conducted a retrospective analysis of patients who developed respiratory tract infections post-CHS and were admitted to our cardiac center between July 2021 and December 2022. The patients were categorized into the following two groups based on the diagnostic method used: (I) the mNGS group (comprising 62 patients); and (II) the conventional microbiological test (CMT) group (comprising 70 patients). Bronchoalveolar lavage fluid (BALF) samples from these patients were tested to identify pathogens.
UNASSIGNED: The mNGS group had significantly higher detection rates for both viral infections and mixed viral infections than the CMT group (56.45% vs. 17.14%, P<0.001, and 80.00% vs. 16.67%, P<0.001, respectively). In the mNGS group, 19.35% of the patients received antiviral therapy, and 61.29% received an anti-infective regimen adjustment. Conversely, in the CMT group, only 4.29% received antiviral therapy, and 28.57% received an anti-infective regimen adjustment. A higher percentage of patients showed improved respiratory symptoms in the mNGS group than the CMT group (74.19% vs. 44.29%, P=0.001). Additionally, the mNGS group had a shorter duration of mechanical ventilation and a reduced length of stay in the cardiac intensive care unit than the CMT group (P=0.012).
UNASSIGNED: Using mNGS for BALF enhances the detection of respiratory viral infections and coexisting viral infections post-CHS. This facilitates more precise treatment strategies and could potentially lead to improved patient outcomes.