新生儿败血症患者血液中新型细菌的鉴定

IF 0.5 Q4 PEDIATRICS Egyptian Pediatric Association Gazette Pub Date : 2024-06-24 DOI:10.1186/s43054-024-00284-0
Yi Wu, Weiming Gong, Zhenni Wang, Mengjie Luo
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引用次数: 0

摘要

新生儿败血症的临床诊断仍然困难重重,因为存在培养细菌和避免污染等各种挑战。因此,本研究旨在通过新一代测序技术(NGS)鉴定临床诊断为新生儿败血症患者的细菌病原体。通过比较患有新生儿败血症的新生儿和健康对照组婴儿的样本,进行了高通量 NGS 和传统培养鉴定。将所有血液样本分别接种到厌氧瓶和需氧瓶中,在 37 ℃ 下培养 7 天,然后对阳性样本进行鉴定。利用聚合酶链反应(PCR)分析通过高通量 NGS 鉴定出的新型细菌,并通过 Sanger 测序验证 PCR 产物。采用 Wilcoxon 秩和检验和卡方检验来评估各组间物种丰度差异的显著性。受试者均在深圳市第七人民医院儿科和深圳市人民医院龙华分院儿科临床诊断和住院治疗。实验在深圳市第七人民医院进行。实验组包括 45 名临床诊断为新生儿败血症的新生儿(年龄:0-28 天;男 28 名,女 17 名)。对照组包括 15 名 0-28 天的正常新生儿(7 男 8 女)。临床诊断为新生儿败血症的患者中,高通量 NGS 的细菌阳性率为 44%(20/45),而传统细菌培养鉴定的阳性率为 0%(0/45)。鉴定出的四种主要细菌是凯氏无氧芽孢杆菌(Anoxybacillus kestanbolensis)、硫杆菌(Geobacillus vulcani)、氧托卡克雷伯氏菌(Klebsiella oxytoca)和吉鲁阿氏不动杆菌(Acinetobacter guillouiae)。新生儿败血症患者中新发现的 A. kestanbolensis、G. vulcani、K. oxytoca 和 A. guillouiae 细菌是通过高通量 NGS 鉴定的。新生儿败血症可能由母体宫内感染或产道感染引起,临床治愈率较高。由于缺乏培养这些细菌的方法,它们在新生儿败血症中的作用仍不明确。对于疑似诊断和临床诊断为新生儿败血症的患者,明确诊断不能仅仅依靠细菌培养鉴定,还应采用其他有效的诊断技术。
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Identification of novel bacterial species in the blood of patients with neonatal sepsis
The clinical diagnosis of neonatal sepsis remains difficult because of various challenges, such as culturing the bacteria and avoiding contamination. Therefore, this study aimed to identify bacterial pathogens in patients with clinically diagnosed neonatal sepsis by next-generation sequencing (NGS). High-throughput NGS and traditional culture identification were performed by comparing samples from newborns with neonatal sepsis with healthy control infants. All blood samples were separately inoculated into anaerobic and aerobic bottles and incubated for 7 days at 37 °C, the positive specimens were then identified. Novel bacteria identified through high-throughput NGS were analysed using polymerase chain reaction (PCR), PCR products were verified by Sanger sequencing. Wilcoxon rank-sum and chi-square tests were performed to assess the significance of differences in species abundance between groups. Subjects were clinically diagnosed and hospitalized at the Pediatrics Department of Shenzhen Seventh People’s Hospital and Pediatrics Department of the Longhua Branch of Shenzhen People’s Hospital. Experiments were performed at the Shenzhen Seventh People’s Hospital. The experimental group comprised 45 newborns clinically diagnosed with neonatal sepsis (age: 0–28 days; 28 males, 17 females). Fifteen normal newborns aged 0–28 days (7 males, 8 females) were included as the control group. High-throughput NGS showed a positivity rate of 44% (20/45) for bacteria in patients clinically diagnosed with neonatal sepsis, whereas traditional bacterial culture identification showed a positivity rate of 0% (0/45). The four main bacterial species identified were Anoxybacillus kestanbolensis, Geobacillus vulcani, Klebsiella oxytoca, and Acinetobacter guillouiae. A. kestanbolensis, G. vulcani, K. oxytoca, and A. guillouiae, newly discovered bacteria in patients with neonatal sepsis, were identified with high-throughput NGS. Which may result from maternal intrauterine infection or birth-canal infection and have a high clinical-cure rate. Owing to a lack of methods to culture these bacteria, their role in neonatal sepsis remains unclear. A definite diagnosis cannot rely solely on bacterial culture identification for patients with a suspected diagnosis and clinical diagnosis of neonatal sepsis and should involve other effective diagnostic techniques.
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来源期刊
自引率
0.00%
发文量
32
审稿时长
9 weeks
期刊介绍: The Gazette is the official journal of the Egyptian Pediatric Association. The main purpose of the Gazette is to provide a place for the publication of high-quality papers documenting recent advances and new developments in both pediatrics and pediatric surgery in clinical and experimental settings. An equally important purpose of the Gazette is to publish local and regional issues related to children and child care. The Gazette welcomes original papers, review articles, case reports and short communications as well as short technical reports. Papers submitted to the Gazette are peer-reviewed by a large review board. The Gazette also offers CME quizzes, credits for which can be claimed from either the EPA website or the EPA headquarters. Fields of interest: all aspects of pediatrics, pediatric surgery, child health and child care. The Gazette complies with the Uniform Requirements for Manuscripts submitted to biomedical journals as recommended by the International Committee of Medical Journal Editors (ICMJE).
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