Application value of metagenomic next-generation sequencing with alveolar lavage fluid under electronic bronchoscope in ventilator-associated pneumonia
Objective To explore the application value of metagenomic next-generation sequencing(mNGS)with alveolar lavage fluid under electronic bronchoscope in ventilator-associated pneumonia(VAP),and to provide relevant reference for clinical diagnosis and targeted treatment of patients.Methods 40 cases patients with VAP were selected as the research subjects.According to the random numerical table method,they were divided into control group and mNGS group,with 20 cases in each group.Both groups underwent alveolar lavage by electronic bronchoscope.The control group was detected by traditional pathogenic microorganisms,and the mNGS group was detected by mNGS.Both groups were compared in terms of detection rate of pathogen species,number of pathogen species,antibiotic use intensity(including antibiotic usage rate and duration),mechanical ventilation time,length of intensive care unit(ICU)stay,incidence of multiple organ dysfunction syndrome(MODS)were compared between the two groups,and diagnostic efficacy of the two detection methods for VAP was compared.Results The bacterial detection rate of the mNGS group was 80.00%,which was significantly higher than that of the control group's 20.00%(P＜0.05).There was no significant difference in the detection rates of fungus and virus between the two groups(P＞0.05).The detection rate of pathogen species＞2 in the mNGS group was 30.00%,which was significantly higher than that in the control group's 0(P＜0.05).The area under the curve(AUC)of mNGS in the diagnosis of VAP was 0.941,which was significantly higher than 0.714 in the traditional detection of pathogenic microorganisms(P＜0.05).The antibiotic usage rate of 55.00%in the mNGS group was significantly lower than the control group's 90.00%;and antibiotic usage duration,mechanical ventilation time and length of ICU stay in mNGS group were(11.21±2.08),(11.96±2.90)and(19.03±3.94)d,which were significantly shorter than(15.87±2.53),(15.47±3.82)and(22.18±4.55)d in the control group;and the incidence of MODS in mNGS group was 5.00%,which was significantly lower than the control group's 30.00%(P＜0.05).Conclusion The application of mNGS with alveolar lavage fluid under electronic bronchoscope in VAP patients is of high value,which can effectively improve the detection rate of infectious pathogens in patients,significantly reduce the intensity of antibiotic use and mechanical ventilation time,which is of great significance for the rapid and accurate diagnosis of patients'disease and timely adoption of targeted treatment measures.
Ventilator-associated pneumoniaElectronic bronchoscopeAlveolar lavage fluidMetagenomic next-generation sequencingApplication value
万方数据
维普
