关键词:

肺泡灌洗液, 宏基因组测序, 重症社区获得性肺炎

Abstract:

Objective To investigate the value of bronchoalveolar lavage fluids（BALF）metagenome next⁃ generation sequencing in the diagnosis of severe community ⁃ acquired pneumonia in children. Methods From March 2019 to February 2020，29 children with severe community⁃acquired pneumonia treated with bronchoalveolar lavage were included in the study. The BALFs obtained during lavage were detected by both traditional etiology and metagenomics next generation sequencing（mNGS）simultaneously，and the diagnostic efficacy of the two detection methods for etiology of severe community⁃acquired pneumonia was analyzed. Results The detection rate of bacteria in the BALFs of all 29 children by mNGS was significantly higher than that by the traditional detection methods （58.6% vs. 20.7%）（P = 0.003）. The positive rate of pathogens and the infection detection rate of more than two pathogens by mNGS were significantly higher than by the traditional detection method（93.1% vs. 72.4%，34.5% vs. 0%；P = 0.041，P = 0.001）. In terms of the consistency between MNGS and traditional detection results，the negative results of culture were more than the negative results of MNGS in the pathogens with inconsistent results of the two detection methods. The detection rate of compound infections by mNGS was significantly higher than by the traditional detection methods（58.6% vs. 27.6%，P = 0.017）. Conclusion In children with severe community⁃ acquired pneumonia，the detection rate of bacterial pathogens from BALF by way of mNGS is higher than by tradi⁃ tional detection methods，especially for bacterial and compound infections. So mNGS can provide early diagnosis and treatment basis for severe community⁃acquired pneumonia.

Key words:

bronchoalveolar lavage fluid, metagenome next?generation sequencing, severe community?acquired , pneumonia