宏基因二代测序技术对脊柱感染病原学诊断的价值

目的:探讨宏基因二代测序(metagenomic next-generation sequencing,mNGS)技术对脊柱感染病原学诊断的价值。方法:回顾性分析2018年1月至2019年12月复旦大学附属中山医院收治的24例疑似脊柱感染患者的病例资料,采用常规微生物培养法和mNGS技术检测脊柱组织标本。结果:mNGS总体检测阳性率高于常规培养法(62.5%vs 35.0%),mNGS平均耗时36～48 h,明显短于常规培养法的平均天数21.8 d。脊柱感染主要检出病原体为结核分枝杆菌、金黄色葡萄球菌、大肠埃希菌。结论:mNGS能够快速检测脊柱感染病原体,为临床早期精准治疗提供重要的病原学依据。

Etiological dignostic value of metagenomic next-generation sequencing in spinal infection

Objective: To evaluate the value of next-generation sequencing in the diagnosis of pathogens of spinal infection. Methods: A retrospective analysis was performed and twenty-four hospitalized patients with spinal infection in Zhongshan Hospital,Fudan University from January 2018 to December 2019. Spinal tissues were sent for microbial assay and next-generation sequencing. Results: The overall positive rate of next-generation sequencing was higher than that of culture (62.5% vs 30.3%, P=0.07) although there was no significant difference due to the small sample size. The average turn-around time of next-generation sequencing was 36-48h, significantly shorter than that of culture (21.8 days). In our study, the main pathogens of spinal infection were Mycobacterium Tuberculosis Complex, Staphylococcus aureus and Escherichia Coli. For those had negative pathology and microbiology results, NGS provided an important basis for therapeutic regimen. Conclusion: NGS is effective in quick detection of spinal infection pathogen, which can provide important etiological basis for early precise treatment.