Application of pulmonary alveolar lavage fluid mNGS to detect pathogens of severe lower respiratory tract infection in neurosurgery
Objective To analyze the detection of pathogens and Klebsiella pneumoniae resis-tance genes in alveolar lavage fluid of patients with severe lower respiratory tract infection in neurosurgery us-ing metagenomic next generation sequencing(mNGS).Methods A total of 196 patients with severe lower re-spiratory tract infections in the Department of neurosurgery were admitted to Henan Provincial People's Hospi-tal from June 2020 to June 2022 and were retrospectively selected as the study subjects.Alveolar lavage fluid samples were collected from these patients for routine etiological and mNGS detection.Pathogens were isolated and identified,and the differences between the two detection methods were calculated.The drug resistance gene and drug susceptibility tests of Klebsiella pneumoniae were also detected.Results The positive rate of conventional etiology detection was 62.42%(122/196),while that of mNGS detection was 88.27%(173/196)(χ2=35.631,P<0.05).Resistance genes of Klebsiella pneumoniae were detectedusing the mNGS technique,including ultra-broad spectrum β-lactamase genes(SHV,TEM)and carbapenemase genes(KPC).Results from drug susceptibility tests showed that the resistance rates of Klebsiella pneumoniae to cefzorim,cefurox-ime and ceftriaxone were 75.00%,66.67%and 54.17%,respectively.The resistance rates to biapenem and me-ropenem were 16.67%and 12.50%,respectively.Conclusion The mNGS technique can effectively improve the positive detection rate of severe lower respiratory tract infections in neurosurgery.It can also assist in evalu-ating antimicrobial resistance genes of Klebsiella pneumoniae.
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