摘要
目的探讨宏基因二代测序(next-generation sequencing technology,NGS)在脊柱感染治疗中的临床价值。方法收集2018年6月至2020年12月年在青岛大学附属上海德济医院行开放手术治疗的57例脊柱感染患者的临床资料进行回顾性对比分析研究,其中男性41例,女性16例;年龄21~76岁,平均年龄为(55.32±12.56)岁。感染部位:颈椎10例,胸椎20例,腰椎27例。对病灶组织采用常规微生物培养和NGS检测,观察检测报告阳性率和检测报告时间。结果38例患者的病灶组织中NGS检测出致病原,阳性率为66.7%,其中葡萄球菌12例,链球菌6例,肠球菌5例,大肠埃希菌2例,肺炎克雷伯菌2例,布氏杆菌1例;真菌8例,病毒12例,结核分支杆菌12例,检测周期24~36 h;10例患者中常规微生物培养出病原菌,阳性率为26.3%,其中葡萄球菌4例、链球菌2例、肠球菌2例、大肠埃希菌1例,真菌1例,检测周期3~7 d。NGS相比于常规微生物培养,检测阳性率显著提高,检测报告时间明显减少,差异有统计学意义(P<0.001)。结论NGS能够更加快速、准确检测出脊柱感染致病原,为临床早期针对致病原治疗提供重要依据。
Objective To investigate the clinical value of next-generation sequencing technology(NGS)in the treatment of spinal infection.Methods The clinical data of 57 patients with spinal infection who underwent open surgery in Shanghai Deji Hospital Affiliated to Qingdao University from June 2018 to December 2020 were collected for a retrospective comparative analysis,including 41 males and 16 females.The patients aged 21 to 76,with an average age of(55.32±12.56)years old.According to the infection sites,there were 10 cases of cervical spine,20 cases of thoracic spine,and 27 cases of lumbar spine.Routine microbial culture and NGS testing were used for the lesion tissue,and the positive rate of the test report and the time of the test report were observed.Results The pathogens were detected by NGS in the lesions of 38 patients,and the positive rate was 66.7%,including 12 cases of Staphylococcus,6 cases of Streptococcus,5 cases of Enterococcus,2 cases of Klebsiella pneumoniae,2 cases of Escherichia coli,1 case of Brucella,8 cases of fungi,12 cases of virus,and 12 cases of Mycobacterium tuberculosis.The detection cycle was 24 to 36 hours.Among the 10 patients,the pathogenic bacteria were cultured by routine microbial culture,and the positive rate was 26.3%,including 4 cases of Staphylococcus,2 cases of Streptococcus,2 cases of Enterococcus,1 case of Escherichia coli,and 1 case of fungi.The detection period was 3 to 7 days.Compared with conventional microbial culture,the positive rate of NGS detection was significantly increased,and the detection reporting time was significantly reduced,and the difference was statistically significant(P<0.001).Conclusion NGS can detect the pathogens of spinal infection more quickly and accurately,which provides an important basis for early clinical treatment of pathogens.
作者
刘春
朱超
臧雨峰
黄必军
何博
张振
张玉发
钱明
Liu Chun;Zhu Chao;Zang Yufeng;Huang Bijun;He Bo;Zhang Zhen;Zhang Yufa;Qian Ming(Department of Orthopaedics,Shanghai Deji Hospital Affiliated to Qingdao University,Shanghai 200331,China;Department of Laboratory Medicine,Shanghai Deji Hospital Affiliated to Qingdao University,Shanghai 200331,China;Department of Orthopaedics,Changzheng Hospital Affiliated to Naval Medical University,Shanghai 200003)
出处
《实用骨科杂志》
2022年第6期509-511,536,共4页
Journal of Practical Orthopaedics
关键词
脊柱感染
检测方法
宏基因二代测序
常规微生物培养
spinal infection
detection method
metagenomic next-generation sequencing
conventional microbial culture
