支气管肺泡灌洗液病原体靶向高通量测序对肺结核的诊断价值

媛媛 唐(潍坊市第二人民医院，中国)
艳艳 张(潍坊市第二人民医院，中国)
寒寒 朱(潍坊市第二人民医院，中国)
素云 袁(潍坊市第二人民医院，中国)
芳 徐(潍坊市第二人民医院，中国)

摘要

目的：探讨支气管肺泡灌洗液病原体靶向高通量测序与传统检验方法诊断肺结核的效能及对肺结核及结核性混合感染的诊断价值。方法：2023年8月—2024年8月潍坊市第二人民医院诊断为肺结核患者的93例肺泡灌洗液标本，分别采用病原体靶向高通量测序、传统分子生物学检测及培养检测，分析传统检验方法与病原体靶向高通量测序法对结核分枝杆菌及结核性混合感染的诊断效能。结果：支气管肺泡灌洗液中Xpert MTB/RIF、qRT-PCR法以及tNGS别为：40.9%、38.7%、54.8%。qRT-PCR法与tNGS法比较，差异具有统计学意义（P＜0.05）。传统分子生物学法和tNGS法在检测MTB的灵敏度、特异度分别为92.1%、85.2%和97.4%、74.5%，差异有统计学意义（P＜0.05）。传统检测法以及tNGS33.3%、51.0%，差异有统计学意义（P＜0.05）结论：病原体靶向高通量测序诊断结核分枝感染及结核性混合感染的效能高于传统检验方法。

关键词

病原体靶向高通量测序；肺结核；混合性感染

参考

Singh V. Tuberculosis treatment-shortening[J]. Drug Discov Today, 2024, 29(5): 103955.

Gu W, Miller S, Chiu CY. Clinical Metagenomic Next-Generation Sequencing for Pathogen Detection[J]. Annu Rev Pathol, 2019, 14:319-338.

Hilt EE, Ferrieri P. Next Generation and Other Sequencing Technologies in Diagnostic Microbiology and Infectious Diseases[J]. Genes (Basel), 2022, 13(9):1566.

肺结核诊断WS 288—2017[J].中国感染控制杂志,2018,17(7):642-652.

Zhonghua Jie, He He, Hu Xi, et al. Consensus of clinical pathways of metagenomic next-generation sequencing test in diagnosis of lower respiratory tract infections in China[J]. Chinese Thoracic Society, 2023, 46(4):322-335.

肺结核诊断标准(WS 288—2017)[J].新发传染病电子杂志,2018,3(1):59-61.

Iyer A, Ndlovu Z, Sharma J, et al. Operationalising targeted next-generation sequencing for routine diagnosis of drug-resistant TB[J]. Public Health Action,2023,13(2):43-49.

Dookie N, Khan A, Padayatchi N, et al. Application of Next Generation Sequencing for Diagnosis and Clinical Management of Drug-Resistant Tuberculosis: Updates on Recent Developments in the Field[J]. Front Microbiol, 2022,13:775030.

Cabibbe AM, Spitaleri A, Battaglia S. Application of Targeted Next-Generation Sequencing Assay on a Portable Sequencing Platform for Culture-Free Detection of Drug-Resistant Tuberculosis from Clinical Samples[J]. Clin Microbiol, 2020, 58(10): e00632-620.

Colman RE, Mace A, Seifert M, et al. Whole-genome and targeted sequencing of drug-resistant Mycobacterium tuberculosis on the iSeq100 and MiSeq: A performance, ease-of-use, and cost evaluation[J]. PLoS Med, 2019, 16(4): e1002794.

DOI: http://dx.doi.org/10.12345/yzlcyxzz.v7i10.21679