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不同取材方法及检测技术在重症肺炎病原学诊断中的应用

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目的:不同取材方法标本的合格率、不同微生物检测技术结果阳性率有差异,探究不同取材方法及检测技术在重症肺炎病原学诊断中的应用,以期提高病原学诊断的准确性.方法:回顾性分析2018年1月—2020年12月中国人民解放军联勤保障部队第九〇四医院收治的123例重症肺炎患者的临床资料,同时收集患者经鼻或气管插管留痰培养、肺泡灌洗液培养、肺泡灌洗液宏基因组二代测序技术(mNGS)病原检测等数据,对标本的合格率及阳性率进行分析.结果:123例患者中经鼻或者气管插管留痰标本合格率70%、病原菌生长41例(33.3%),肺泡灌洗液标本合格率92%、病原菌生长76例(61.8%)、肺泡灌洗液mNGS病原菌核酸片段检出107例(86.9%).经抗感染、抗休克、器官支持等治疗后,115例患者治愈出院,8例死亡.结论:肺泡灌洗液mNGS可以提高重症肺炎患者病原诊断阳性率,可为临床治疗提供依据.
Application of Different Sampling Methods and Detection Techniques in the Pathogenetic Diagnosis of Severe Pneumonia
Objective:The qualification rate of specimens from different sampling methods and the positive rate of results from different microbial detection techniques varied,and the application of different sampling methods and detection techniques in the pathogenetic diagnosis of severe pneumonia was explored with a view to improving the accuracy of pathogenetic diagnosis.Methods:The clinical data of 123 patients with severe pneumonia admitted to the hospital from January 2018 to December 2020 were retrospectively analyzed.Data on patients'sputum culture by transnasal or tracheal intubation,alveolar lavage fluid culture,and alveolar lavage fluid macro-genomic second-generation sequencing technology(mNGS)pathogen detection were also collected,and specimens were analyzed for pass rates and positive rates.Results:Of the 123 patients,70% of the sputum specimens retained by transnasal or tracheal intubation were qualified,41(33.3%)had pathogenic bacterial growth,92%of the alveolar lavage specimens were qualified,76(61.8%)had pathogenic bacterial growth,and 107(86.9%)had nucleic acid fragments of pathogenic bacteria detected in mNGS of alveolar lavage.After treatment with anti-infection,anti-shock,and organ support,115 patients were cured and discharged,and 8 died.Conclusion:Alveolar lavage mNGS can increase the positive rate of pathogen diagnosis in patients with severe pneumonia,which may provide a basis for clinical treatment.

Severe pneumoniaAlveolar lavage fluidMacrogenomic second-generation sequencing technologySputum culture

刘龙群、唐敏、张维维、吴可人、杨艳

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中国人民解放军联勤保障部队第九〇四医院呼吸内科,江苏 无锡 214000

重症肺炎 肺泡灌洗液 宏基因组二代测序技术 痰培养

2024

黑龙江医学
中华医学会黑龙江分会

黑龙江医学

影响因子:0.714
ISSN:1004-5775
年,卷(期):2024.48(3)
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