Laboratory Medicine ›› 2022, Vol. 37 ›› Issue (9): 855-859.DOI: 10.3969/j.issn.1673-8640.2022.09.012
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WEN Jing, SHI Rui, XIE Jia, LIU Feng, LI Guang, REN Jingjing, LEI Xiaoru, GUO Xiaobo, SONG Yanping()
Received:
2021-08-04
Revised:
2022-07-19
Online:
2022-09-30
Published:
2022-10-25
Contact:
SONG Yanping
CLC Number:
WEN Jing, SHI Rui, XIE Jia, LIU Feng, LI Guang, REN Jingjing, LEI Xiaoru, GUO Xiaobo, SONG Yanping. Clinical application of metagenomic next-generation sequencing for determining pathogens in febrile neutropenic patients[J]. Laboratory Medicine, 2022, 37(9): 855-859.
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基本特征 | 例数/例 | 百分比/% |
---|---|---|
年龄 | ||
20~50岁 | 5 | 26.3 |
>50岁 | 14 | 73.7 |
性别 | ||
男性 | 10 | 52.6 |
女性 | 9 | 47.4 |
诊断 | ||
急性髓系白血病 | 7 | 36.8 |
淋巴瘤 | 4 | 21.1 |
骨髓增生异常综合征 | 3 | 15.8 |
多发性骨髓瘤 | 2 | 10.5 |
骨髓增殖性肿瘤 | 1 | 5.26 |
其他 | 2 | 10.5 |
样本送检时中性粒细胞水平 | ||
(0.1~0.5)×109/L | 12 | 63.2 |
<0.1×109/L | 7 | 36.8 |
SOFA评分 | ||
0~2分 | 4 | 21.1 |
3~5分 | 10 | 52.6 |
6~9分 | 3 | 15.8 |
>9分 | 2 | 10.5 |
发热天数 | ||
<14 d | 7 | 36.8 |
14~21 d | 9 | 47.4 |
>21 d | 3 | 15.8 |
基本特征 | 例数/例 | 百分比/% |
---|---|---|
年龄 | ||
20~50岁 | 5 | 26.3 |
>50岁 | 14 | 73.7 |
性别 | ||
男性 | 10 | 52.6 |
女性 | 9 | 47.4 |
诊断 | ||
急性髓系白血病 | 7 | 36.8 |
淋巴瘤 | 4 | 21.1 |
骨髓增生异常综合征 | 3 | 15.8 |
多发性骨髓瘤 | 2 | 10.5 |
骨髓增殖性肿瘤 | 1 | 5.26 |
其他 | 2 | 10.5 |
样本送检时中性粒细胞水平 | ||
(0.1~0.5)×109/L | 12 | 63.2 |
<0.1×109/L | 7 | 36.8 |
SOFA评分 | ||
0~2分 | 4 | 21.1 |
3~5分 | 10 | 52.6 |
6~9分 | 3 | 15.8 |
>9分 | 2 | 10.5 |
发热天数 | ||
<14 d | 7 | 36.8 |
14~21 d | 9 | 47.4 |
>21 d | 3 | 15.8 |
样本编号 | mNGS | 微生物培养 | 免疫学相关检测 |
---|---|---|---|
1 | 人疱疹病毒6B型、人疱疹病毒4型(EB病毒)、铜绿假单胞菌、屎肠球菌、库德里阿兹威氏、毕赤酵母、藤仓镰刀菌 | 血培养(+) | G试验(+) EB病毒DNA(+) |
2 | 白念珠菌、人疱疹病毒4型(EB病毒)、人疱疹病毒7型、副血链球菌 | 血培养(-) | G试验(+) 病毒相关检测(-) |
3 | 嗜麦芽窄食单胞菌、肺炎支原体、单纯疱疹病毒I型 | 胸腔积液、腹腔积液培养(-) | GNBL检测、G试验、GM试验(-) |
4 | 人疱疹病毒4型(EB病毒)、溶血性链球菌、大肠埃希菌 | 血培养(-) | EB病毒DNA(+) |
5 | 乳酸乳球菌 | 血培养(-) | GNBL检测、G试验、GM试验(-) |
6 | 金黄色葡萄球菌 | 血培养(+) | GNBL检测、G试验、GM试验(-) |
7 | 肺炎克雷伯菌、白念珠菌 | 血培养(+) | G试验(+) |
8 | 鲍曼不动杆菌 | 血培养(-) | GNBL(+) |
9 | 铜绿假单胞菌、产黄青霉菌 | 血培养(-) | GNBL检测、G试验、GM试验(-) |
10 | 大肠埃希菌 | 尿培养(+) | GNBL(+) |
11 | 流感嗜血杆菌 | 胸腔积液、腹腔积液培养(-) | GNBL(+) |
12 | 铜绿假单胞菌 | 血培养(-) | GNBL检测、G试验、GM试验(-) |
13 | 肺炎克雷伯菌 | 血培养(+) | GNBL检测(+) |
14 | — | 血培养(+) | GNBL检测(+)、G试验、GM试验(-) |
15 | — | 脑脊液培养(-) | GNBL检测、G试验、GM试验(-) |
16 | — | 血培养(-) | GNBL检测、G试验、GM试验(-) |
17 | — | 血培养(-) | GNBL检测、G试验、GM试验(-) |
18 | — | 血培养(-) | GNBL检测、G试验、GM试验(-) |
19 | — | 血培养(-) | GNBL检测、G试验、GM试验(-) |
样本编号 | mNGS | 微生物培养 | 免疫学相关检测 |
---|---|---|---|
1 | 人疱疹病毒6B型、人疱疹病毒4型(EB病毒)、铜绿假单胞菌、屎肠球菌、库德里阿兹威氏、毕赤酵母、藤仓镰刀菌 | 血培养(+) | G试验(+) EB病毒DNA(+) |
2 | 白念珠菌、人疱疹病毒4型(EB病毒)、人疱疹病毒7型、副血链球菌 | 血培养(-) | G试验(+) 病毒相关检测(-) |
3 | 嗜麦芽窄食单胞菌、肺炎支原体、单纯疱疹病毒I型 | 胸腔积液、腹腔积液培养(-) | GNBL检测、G试验、GM试验(-) |
4 | 人疱疹病毒4型(EB病毒)、溶血性链球菌、大肠埃希菌 | 血培养(-) | EB病毒DNA(+) |
5 | 乳酸乳球菌 | 血培养(-) | GNBL检测、G试验、GM试验(-) |
6 | 金黄色葡萄球菌 | 血培养(+) | GNBL检测、G试验、GM试验(-) |
7 | 肺炎克雷伯菌、白念珠菌 | 血培养(+) | G试验(+) |
8 | 鲍曼不动杆菌 | 血培养(-) | GNBL(+) |
9 | 铜绿假单胞菌、产黄青霉菌 | 血培养(-) | GNBL检测、G试验、GM试验(-) |
10 | 大肠埃希菌 | 尿培养(+) | GNBL(+) |
11 | 流感嗜血杆菌 | 胸腔积液、腹腔积液培养(-) | GNBL(+) |
12 | 铜绿假单胞菌 | 血培养(-) | GNBL检测、G试验、GM试验(-) |
13 | 肺炎克雷伯菌 | 血培养(+) | GNBL检测(+) |
14 | — | 血培养(+) | GNBL检测(+)、G试验、GM试验(-) |
15 | — | 脑脊液培养(-) | GNBL检测、G试验、GM试验(-) |
16 | — | 血培养(-) | GNBL检测、G试验、GM试验(-) |
17 | — | 血培养(-) | GNBL检测、G试验、GM试验(-) |
18 | — | 血培养(-) | GNBL检测、G试验、GM试验(-) |
19 | — | 血培养(-) | GNBL检测、G试验、GM试验(-) |
方法 | 敏感性/% | 特异性/% | 约登指数 |
---|---|---|---|
mNGS | 72.10 | 68.46 | 0.41 |
微生物培养 | 30.70 | 82.94 | 0.14 |
免疫学相关检测 | 70.90 | 30.70 | 0.02 |
χ2值 | 14.995 | 27.184 | 5.184 |
P值 | 0.038 | 0.014 | 0.031 |
方法 | 敏感性/% | 特异性/% | 约登指数 |
---|---|---|---|
mNGS | 72.10 | 68.46 | 0.41 |
微生物培养 | 30.70 | 82.94 | 0.14 |
免疫学相关检测 | 70.90 | 30.70 | 0.02 |
χ2值 | 14.995 | 27.184 | 5.184 |
P值 | 0.038 | 0.014 | 0.031 |
[1] |
LAKSHMAIAH K C, MALABAGI A S, GOVINDBABU, et al. Febrile neutropenia in hematological malignancies:clinical and microbiological profile and outcome in high risk patients[J]. J Lab Physicians, 2015, 7(2):116-120.
DOI URL |
[2] |
KENG M K, SEKERES M A. Febrile neutropenia in hematologic malignancies[J]. Curr Hematol Malig Rep, 2013, 8(4):370-378.
DOI URL |
[3] |
MWAIGWISYA S, ASSIRI R A, O'GRADY J. Emerging commercial molecular tests for the diagnosis of bloodstream infection[J]. Expert Rev Mol Diagn, 2015, 15(5):681-692.
DOI PMID |
[4] |
TAPLITZ R A, KENNEDY E B, BOW E J, et al. Outpatient management of fever and neutropenia in adults treated for malignancy:American Society of Clinical Oncology and Infectious Diseases Society of America Clinical Practice Guideline update[J]. J Clin Oncol, 2018, 36(14):1443-1453.
DOI URL |
[5] |
FLOWERS C R, SEIDENDELD J, BOW E J, et al. Antimicrobial prophylaxis and outpatient management of fever and neutropenia in adults treated for malignancy:American Society of Clinical Oncology clinical practice guideline[J]. J Clin Oncol, 2013, 31(6):794-810.
DOI URL |
[6] |
BOSSAER J B, HALL P D, GARRETT-MAYER E. Incidence of vancomycin-resistant enterococci(VRE)infection in high-risk febrile neutropenic patients colonized with VRE[J]. Support Care Cancer, 2010, 19(2):231-237.
DOI URL |
[7] |
SCHMIDT-HIEBER M, TESCHNER D, MASCHMEYER G, et al. Management of febrile neutropenia in the perspective of antimicrobial de-escalation and discontinuation[J]. Expert Rev Anti Infect Ther, 2019, 17(12):983-995.
DOI URL |
[8] |
HORIBA K, TORII Y, HARA Y, et al. 242. Comprehensive pathogen detection for pediatric febrile neutropenia by metagenomic next-generation sequencing[J]. Open Forum Infect Dis, 2019, 6(Suppl 2):S137-S138.
DOI URL |
[9] | 陶悦, 傅启华, 莫茜. 病原宏基因组测序在新型冠状病毒检测中的应用与挑战[J]. 中华检验医学杂志, 2020, 43(3):217-220. |
[10] |
SIMNER P J, MILLER S, CARROLL K C. Understanding the promises and hurdles of metagenomic next-generation sequencing as a diagnostic tool for infectious diseases[J]. Clin Infect Dis, 2018, 66(5):778-788.
DOI PMID |
[11] |
AI J W, WENG S S, CHENG Q, et al. Human endophthalmitis caused by pseudorabies virus infection,China,2017[J]. Emerg Infect Dis, 2018, 24(6):1087-1090.
DOI URL |
[12] |
LONG Y, ZHANG Y, GONG Y, et al. Diagnosis of sepsis with cell-free DNA by next-generation sequencing technology in ICU patients[J]. Arch Med Res, 2016, 47(5):365-371.
DOI PMID |
[13] |
MIAO Q, MA Y, WANG Q, et al. Microbiological diagnostic performance of metagenomic next-generation sequencing when applied to clinical practice[J]. Clin Infect Dis, 2018, 67(suppl 2):S231-S240.
DOI URL |
[14] |
HOGAN C A, YANG S, GARNERr O B, et al. Clinical impact of metagenomic next-generation sequencing of plasma cell-free DNA for the diagnosis of infectious diseases:a multicenter retrospective cohort study[J]. Clin Infect Dis, 2021, 72(2):239-245.
DOI URL |
[15] | 谢栓栓, 李譞, 李萍, 等. 宏基因二代测序技术对感染性疾病患者的诊断价值及其临床应用[J]. 国际呼吸杂志, 2020, 40(9):641-646. |
[16] |
HAN D, LI Z, LI R, et al. mNGS in clinical microbiology laboratories:on the road to maturity[J]. Crit Rev Microbiol, 2019, 45(5-6):668-685.
DOI URL |
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