Email Alerts
RSS
Volume 37 Issue 8
Aug.  2021
Turn off MathJax
Article Contents
Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2021  >  37(8): 764-769
Li F,Yin HN,Hu Q,et al.Application of metagenomic next-generation sequencing technology in pathogen detection in patients with burns and patients with acute or chronic wounds[J].Chin J Burns,2021,37(8):764-769.DOI: 10.3760/cma.j.cn501120-20200623-00322.
Citation: Li F,Yin HN,Hu Q,et al.Application of metagenomic next-generation sequencing technology in pathogen detection in patients with burns and patients with acute or chronic wounds[J].Chin J Burns,2021,37(8):764-769.DOI: 10.3760/cma.j.cn501120-20200623-00322.
shu

Application of metagenomic next-generation sequencing technology in pathogen detection in patients with burns and patients with acute or chronic wounds

doi: 10.3760/cma.j.cn501120-20200623-00322

  • Burns and Plastic Department, the Fourth Medical Center of PLA General Hospital, Beijing 100048, China

Funds:

Military Logistics Scientific Research Plan BWS19C015

More Information
    Abstract
  •   Objective  To explore the value of using metagenomic next-generation sequencing (mNGS) technology to detect pathogens in patients with burns and patients with acute or chronic wounds.  Methods  A retrospective observational study was conducted. From March 2019 to June 2020, 11 patients with burns and patients with acute or chronic wounds (including 10 males and 1 female, aged 23 to 85 years) in the Fourth Medical Center of PLA General Hospital met the inclusion criteria and were recruited. A total of 23 specimens were collected, including 6 whole blood specimens, 1 skin tissue specimen, 1 drained pus specimen, and 15 wound secretion swab specimens. Each specimen was divided into two parts, which were subjected for pathogen detection using microbial culture method and mNGS method, respectively. The number and types of pathogens detected by the 2 methods and the relative abundance detected by the mNGS method were recorded, and the consistency of the two methods were compared. Data were statistically analyzed with paired Wilcoxon rank sum test.  Results  With the microbial culture method, no pathogen was detected in 5 of the 23 specimens, while 35 pathogens were detected in the remaining 18 specimens, belonging to 9 species of bacteria and 2 species of fungi. Five specimens had one pathogen while 9 specimens had 2 pathogens and 4 specimens had 3 pathogens detected in each specimen. With the mNGS method, no pathogen was detected in one of the 23 specimens, while 75 pathogens were detected in the remaining 22 specimens, belonging to 28 species of bacteria, 3 species of fungi, and 3 species of viruses. Eight specimens had one pathogen, 5 specimens had 2 pathogens, 2 specimens had 3 pathogens, 3 specimens had 4 pathogens, 2 specimens had 6 pathogens, and 1 specimen had 7 pathogens, and 1 specimen had 20 pathogens detected in each specimen. The number of pathogens detected in each specimen by microbial culture method was 2 (1, 2) types, which was significantly less than 2 (1, 4) types by mNGS method (Z=3.359, P<0.01). In 5 specimens, no bacteria were detected by microbial culture method but mNGS method detected bacteria in 2 specimens and virus in 2 different specimens. The mNGS method detected two or more types of bacteria in 13 specimens, the relative abundance of bacteria with the 1st relative abundance ranking ranged from 28.8% to 95.9% in each specimen. Of the 23 specimens detected by two detection methods, 7 specimens (30.4%) showed identical detection results, 5 specimens (21.7%) showed totally different detection results, and 11 specimens (47.8%) had partially consistent detection results.  Conclusions  Compared with the traditional microbial culture method, the mNGS method has higher detection sensitivity and stronger capacity to detect pathogens, and can determine the relative abundance of pathogens in mixed infections. As a supplement to the culture method, the mNGS method is expected to play an important role in the diagnosis of infectious pathogens in burns and acute or chronic wounds.

     

    • FullText(HTML)
  • loading
    • References(36)
  • [1]
    ManningJ. Sepsis in the burn patient[J]. Crit Care Nurs Clin North Am, 2018, 30(3):423-430. DOI: 10.1016/j.cnc.2018.05.010.
    [2]
    ZhangPJ, ZouBW, LiouYC, et al. The pathogenesis and diagnosis of sepsis post burn injury[J/OL]. Burns Trauma, 2021, 9:tkaa047[2021-05-30]. https://pubmed.ncbi.nlm.nih.gov/33654698/.DOI: 10.1093/burnst/tkaa047.
    [3]
    PierrakosC,VincentJL.Sepsis biomarkers: a review[J].Crit Care,2010,14(1):R15.DOI: 10.1186/cc8872.
    [4]
    FanSL, MillerNS, LeeJ, et al. Diagnosing sepsis - the role of laboratory medicine[J]. Clin Chim Acta, 2016, 460: 203-210. DOI: 10.1016/j.cca.2016.07.002.
    [5]
    LloydKG, SteenAD, LadauJ, et al. Phylogenetically novel uncultured microbial cells dominate earth microbiomes[J]. mSystems, 2018, 3(5): e00055-18. DOI: 10.1128/mSystems.00055-18.
    [6]
    张敏,李伯安,邱广斌.下一代测序技术在感染性疾病检测上的临床应用[J].中华检验医学杂志,2017,40(7):492-494.DOI: 10.3760/cma.j.issn.1009-9158.2017.07.004.
    [7]
    张坚磊,马小军.感染性疾病病原学诊断新技术与临床应用策略[J].协和医学杂志,2018,9(5):399-403.DOI: 10.3969/j.issn.1674-9081.2018.05.004.
    [8]
    GuW, MillerS, ChiuCY. Clinical metagenomic next-generation sequencing for pathogen detection[J]. Annu Rev Pathol, 2019, 14: 319-338. DOI: 10.1146/annurev-pathmechdis-012418-012751.
    [9]
    邓呈亮, 詹日兴, 刘洋, 等.成年大面积烧伤死亡患者的细菌感染及耐药情况分析[J].中华烧伤杂志, 2016, 32(11): 688-691.DOI: 10.3760/cma.j.issn.1009-2587.2016.11.011.
    [10]
    柴家科. 实用烧伤外科学[M]. 北京: 人民军医出版社, 2014: 218.
    [11]
    BloemsmaGC, DokterJ, BoxmaH, et al. Mortality and causes of death in a burn centre[J]. Burns, 2008, 34(8): 1103-1107. DOI: 10.1016/j.burns.2008.02.010.
    [12]
    LavrentievaA, VoutsasV, KonoglouM, et al. Determinants of outcome in burn ICU patients with septic shock[J]. J Burn Care Res, 2017, 38(1): e172-e179. DOI: 10.1097/BCR.0000000000000337.
    [13]
    SingerM, DeutschmanCS, SeymourCW, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3)[J]. JAMA, 2016, 315(8): 801-810. DOI: 10.1001/jama.2016.0287.
    [14]
    中国医师协会急诊医师分会, 中国研究型医院学会休克与脓毒症专业委员会. 中国脓毒症/脓毒性休克急诊治疗指南(2018)[J]. 感染、炎症、修复, 2019, 20(1): 3-22. DOI: 10.3969/j.issn.1672-8521.2019.01.001.
    [15]
    DeurenbergRH,BathoornE,ChlebowiczMA,et al.Application of next generation sequencing in clinical microbiology and infection prevention[J].J Biotechnol,2017,243:16-24.DOI: 10.1016/j.jbiotec.2016.12.022.
    [16]
    MwaigwisyaS, AssiriRAM, O'GradyJ. Emerging commercial molecular tests for the diagnosis of bloodstream infection[J]. Expert Rev Mol Diagn, 2015, 15(5): 681-692. DOI: 10.1586/14737159.2015.1029459.
    [17]
    LongY, ZhangYX, GongYP, et al. Diagnosis of sepsis with cell-free DNA by next-generation sequencing technology in ICU patients[J]. Arch Med Res, 2016, 47(5): 365-371. DOI: 10.1016/j.arcmed.2016.08.004.
    [18]
    王凯飞, 沈定霞, 刘朝军, 等. 血清降钙素原定量检测与血培养结果的比较[J]. 中华检验医学杂志, 2012, 35(3): 243-246. DOI: 10.3760/cma.j.issn.1009-9158.2012.03.011.
    [19]
    WarhurstG, DunnG, ChadwickP, et al. Rapid detection of health-care-associated bloodstream infection in critical care using multipathogen real-time polymerase chain reaction technology: a diagnostic accuracy study and systematic review[J]. Health Technol Assess, 2015, 19(35): 1-142. DOI: 10.3310/hta19350.
    [20]
    BrennerT, DeckerSO, GrumazS, et al. Next-generation sequencing diagnostics of bacteremia in sepsis (Next GeneSiS-Trial): study protocol of a prospective, observational, noninterventional, multicenter, clinical trial[J]. Medicine (Baltimore), 2018, 97(6): e9868. DOI: 10.1097/MD.0000000000009868.
    [21]
    HuHL, GuoLY, WuHL, et al. Evaluation of next-generation sequencing for the pathogenic diagnosis of children brain abscesses[J]. J Infect, 2019, 78(4):323-337. DOI: 10.1016/j.jinf.2019.01.003.
    [22]
    张军民, 周贵民. 厌氧菌血培养仍是值得重视的问题[J]. 中华检验医学杂志, 2005, 28(10): 979-980. DOI: 10.3760/j:issn:1009-9158.2005.10.002.
    [23]
    洪秀华. 病毒感染的实验诊断方法及其价值[J]. 诊断学理论与实践, 2007, 6(3): 180-184. DOI: 10.3969/j.issn.1671-2870.2007.03.002.
    [24]
    ComarM, D'AccoltiM, CasonC, et al. Introduction of NGS in environmental surveillance for healthcare-sssociated infection control[J]. Microorganisms, 2019, 7(12):708. DOI: 10.3390/microorganisms7120708.
    [25]
    柯创宏, 韩焕钦, 杨天骄, 等. 高通量测序技术检测支气管肺泡灌洗液在婴幼儿肺炎病原学诊断中的价值[J]. 中华实用诊断与治疗杂志, 2020, 34(4): 398-400. DOI: 10.13507/j.issn.1674-3474.2020.04.020.
    [26]
    胡晓熠, 汪明, 王惠明. 高通量测序技术在尿路感染及腹膜透析相关腹膜炎病原学诊断中的价值[J]. 中华实用诊断与治疗杂志, 2021, 35(3): 230-233. DOI: 10.13507/j.issn.1674-3474.2021.03.004.
    [27]
    ChenPX, SunWW, HeYY. Comparison of the next-generation sequencing (NGS) technology with culture methods in the diagnosis of bacterial and fungal infections[J]. J Thorac Dis, 2020, 12(9): 4924-4929. DOI: 10.21037/jtd-20-930.
    [28]
    YinH, XuDL, WangDW. Diagnostic value of next-generation sequencing to detect periprosthetic joint infection[J]. BMC Musculoskelet Disord, 2021, 22(1): 252. DOI: 10.1186/s12891-021-04116-9.
    [29]
    GalazzoG, van BestN, BenedikterBJ, et al. How to count our microbes? The effect of different quantitative microbiome profiling approaches[J]. Front Cell Infect Microbiol, 2020, 10: 403. DOI: 10.3389/fcimb.2020.00403.
    [30]
    中华医学会检验医学分会临床微生物学组, 中华医学会微生物学与免疫学分会临床微生物学组, 中国医疗保健国际交流促进会临床微生物与感染分会. 宏基因组高通量测序技术应用于感染性疾病病原检测中国专家共识[J]. 中华检验医学杂志, 2021, 44(2):107-120. DOI: 10.3760/cma.j.cn114452-20201026-00794.
    [31]
    《中华传染病杂志》编辑委员会.中国宏基因组学第二代测序技术检测感染病原体的临床应用专家共识[J].中华传染病杂志,2020,38(11):681-689.DOI: 10.3760/cma.j.cn311365-20200731-00732.
    [32]
    于威, 孟冬梅. 微生物学及检验技术[M]. 哈尔滨: 黑龙江科学技术出版社, 2008: 138.
    [33]
    梁振山, 曾令兵, 万腊根. 基因组测序技术及其临床应用研究进展[J]. 实验与检验医学, 2016, 34(1): 48-51. DOI: 10.3969/j.issn.1674-1129.2016.01.016.
    [34]
    黄晶晶, 肖盟, 徐英春. 二代测序技术在微生物和感染性疾病中的应用[J]. 协和医学杂志, 2018, 9(5): 448-452. DOI: 10.3969/j.issn.1674-9081.2018.05.014.
    [35]
    杨继勇. 高通量测序技术在感染病原检测中的应用与展望[J]. 中华检验医学杂志, 2020, 43(5): 533-539. DOI: 10.3760/cma.j.cn114452-20190719-00438.
    [36]
    WilsonMR, NaccacheSN, SamayoaE, et al.Actionable diagnosis of neuroleptospirosis by next-generation sequencing[J].N Engl J Med, 2014, 370(25): 2408-2417. DOI: 10.1056/NEJMoal401268.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(1)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (270) PDF downloads(20) Cited by()
    Proportional views
    Related

    Copyright © Chinese Journal of Burns京ICP备07035254号-14

    E-mail：shaoshangzazhi@163.com

    Website：https://zhsszz.xml-journal.net/

    Supported by: Beijing Renhe Information Technology Co. Ltd    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return