宏基因组二代测序在儿童重症感染中的应用价值

目的 分析宏基因组二代测序(metagenomic next-generation sequencing,mNGS)在儿童重症感染性疾病中的应用价值.方法 对2018年6月至2020年12月温州医科大学附属第二医院收治的29例重症感染患儿的临床资料及实验室检查结果进行分析.29例患儿的29份标本(外周血标本27份,胸水...

Value of metagenomic next-generation sequencing in children with severe infectious diseases

Objective To study the application value of metagenomic next-generation sequencing (mNGS) in children with severe infectious diseases. Methods An analysis was performed on the clinical data and laboratory test results of 29 children with severe infection who were admitted to the Second Affiliated Hospital of Wenzhou Medical University from June 2018 to December 2020. Conventional pathogen culture was performed for the 29 specimens (27 peripheral blood specimens and 2 pleural effusion specimens) from the 29 children, and mNGS pathogen detection was performed at the same time. Results Among the 29 children, 2 tested positive by conventional pathogen culture with 2 strains of pathogen, and the detection rate was 7% (2/29); however, 20 children tested positive by mNGS with 38 strains of pathogen, and the detection rate was 69% (20/29). The pathogen detection rate of mNGS was significantly higher than that of conventional pathogen culture (P<0.05), and mNGS could detect the viruses, fungi, and other special pathogens that conventional pathogen culture failed to detect, such as Orientia tsutsugamushi. The univariate analysis showed that gender, routine blood test results, C-reactive protein, procalcitonin, D-dimer, radiological findings, and whether antibiotics were used before admission did not affect the results of mNGS (P>0.05). Conclusions Compared with conventional pathogen culture, mNGS is more sensitive for pathogen detection, with fewer interference factors. Therefore, it is a better pathogenic diagnosis method for severe infectious diseases in children.