摘要
目的:探讨靶向高通量测序(targeted next-generation sequencing,tNGS)技术在非结核分枝杆菌菌种鉴定的应用价值。方法:收集2021年7月至2022年9月,在广州市胸科医院非结核分枝杆菌病诊疗中心住院患者的428份标本进行研究,其中,痰标本312份,支气管肺泡灌洗液标本116份。对上述标本进行tNGS分枝杆菌鉴定(简称“tNGS法”)和微生物培养(BACTEC MGIT 960)+DNA微阵列芯片法(简称“培养法”)进行分枝杆菌菌种鉴定,并对2种方法检测结果进行比较。结果:(1)tNGS法和培养法分别分离出结核分枝杆菌102份和56份,非结核分枝杆菌150份和182份。(2)tNGS法的分枝杆菌检出率为58.88%(252/428),与培养法阳性率55.61%(238/428)比较,差异无统计学意义(χ^(2)=0.936,P=0.333)。(3)以培养法为参照标准,tNGS法检测分枝杆菌的敏感度、特异度、假阴性率、假阳性率、阳性预测值、阴性预测值和Kappa值分别为80.65%(200/248)、92.22%(166/180)、22.43%(48/214)、6.54%(14/214)、93.46%(200/214)、77.57%(166/214)和0.710。结论:tNGS法与培养法一致性良好,具备很好的时效性、敏感度、特异度,利于早期制定临床治疗方案。
Objective:To explore the application value of targeted next-generation sequencing(tNGS)in the identification of non-tuberculous mycobacteria(NTM)strains.Methods:From July 2021 to September 2022,428 samples of hospitalized patients in the NTM Diagnosis and Treatment Center of Guangzhou Chest Hospital were collected for study,including 312 sputum samples and 116 bronchial lavage fluid samples.These samples were identified by tNGS mycobacterium identification(“tNGS”for short)and microbial culture(BACTEC MGIT 960)+DNA microarray chip method(“culture method”for short),and the detection results of the two methods were analyzed.Results:(1)tNGS and culture method respectively isolated 102 and 56 samples of Mycobacterium tuberculosis respectively,and 150 and 182 NTM samples.(2)Detection rate of mycobacterium by tNGS was 58.88%(252/428),but there was no significant difference between tNGS and culture method(55.61%(238/428),χ^(2)=0.936,P=0.333).(3)Taking culture method as the reference standard,the sensitivity,specificity,false negative rate,false positive rate,positive predictive value,negative predictive value and Kappa value of tNGS to detect mycobacterium were 80.65%(200/248),92.22%(166/180),22.43%(48/214),6.54%(14/214),93.46%(200/214),77.57%(166/214)and 0.710,respectively.Conclusion:tNGS result is consistent with culture method,has good timeliness,sensitivity and specificity,which is conducive to formulating clinical treatment plan in the early stage.
作者
陈华
陈品儒
李艳阳
邓政先
许柳清
梁锋
胡锦兴
Chen Hua;Chen Pinru;Li Yanyang;Deng Zhengxian;Xu Liuqing;Liang Feng;Hu Jinxing(Non-Tuberculous Mycobacterial Diseases Diagnosis and Treatment Center,Guangzhou Chest Hospital,State Key Laboratory of Respiratory Disease,Guangzhou 510095,China)
出处
《中国防痨杂志》
CAS
CSCD
2023年第4期362-366,共5页
Chinese Journal of Antituberculosis
基金
广东省医学科学技术研究基金(C2021090)。
关键词
分子序列数据
分枝杆菌属
诊断
鉴别
Molecular sequence data
Mycobacterium
Diagnosis,differential
