宏基因组二代测序对肺炎克雷伯杆菌碳青霉烯耐药性的诊断价值OA
Diagnostic value of metagenomic next-generation sequencing for carbap-enem resistance in klebsiella pneumoniae
目的:探讨宏基因组二代测序(mNGS)对肺炎克雷伯菌碳青霉烯耐药性的诊断价值.方法:回顾性分析2021 年5 月至2024 年3 月郑州大学第一附属医院重症医学科送检的同时进行碳青霉烯耐药基因 mNGS 检测和传统细菌培养的感染患者生物样本数据.以细菌培养的药敏试验结果为金标准,比较两种方法的检测结果,绘制ROC 曲线评价 mNGS 的诊断效能.结果:mNGS 检测出的耐药 blaKPC 基因结果与金标准的一致性好[Kappa(95%CI)=0.873(0.817～0.928)],blaCTX-M、blaTEM 基因检测结果与金标准呈中等一致性[Kappa(95%CI)=0.414(0.311～0.518)、0.419(0.316～0.521)].blaKPC 诊断效能最好,AUC(95%CI)为 0.94(0.91～0.97),敏感度为92.8%、特异度为94.8%、准确率为93.7%.结论:mNGS 可通过快速识别耐碳青霉烯肺炎克雷伯菌耐药基因,早期识别肺炎克雷伯菌对碳青霉烯类抗生素的耐药性.
Aim:To explore the diagnostic value of metagenomic next-generation sequencing(mNGS)for carbapenem resistance in Klebsiella pneumoniae.Methods:A retrospective analysis was conducted on biological sample data from infec-ted patients who underwent both mNGS testing and traditional bacterial culture in the Intensive Care Unit of the First Affilia-ted Hospital of Zhengzhou University from May 2021 to March 2024.Using the antimicrobial susceptibility test results of bacterial culture as the gold standard,the detection results of both methods were compared,and an ROC curve was plotted to evaluate the diagnostic efficacy of mNGS.Results:The consistency of mNGS detection results for the drug-resistant gene blaKPC with the gold standard was good[Kappa(95%CI)=0.873(0.817-0.928)].The detection results of blaCTX-M and blaTEM genes showed moderate consistency with the gold standard[Kappa(95%CI)=0.414(0.311-0.518)and 0.419(0.316-0.521),respectively].blaKPC exhibited the best diagnostic performance,with an AUC(95%CI)of 0.94(0.91-0.97),a sensitivity of 92.8%,a specificity of 94.8%,and an accuracy of 93.7%.Conclusion:mNGS can rapidly identify resistance genes in carbapenem-resistant Klebsiella pneumoniae,enabling early detection of carbapenem resistance in Klebsiella pneumoniae.
王海旭;赵颖颖;胡旗旗;曹萌萌;杜雨新;时学秀;赵楠;张雅文
郑州大学第一附属医院综合 ICU 郑州 450052郑州大学第一附属医院综合 ICU 郑州 450052永煤集团总医院 河南 商丘 476600郑州大学第一附属医院重症医学规培基地 郑州 450052南阳市中心医院 河南 南阳 473000郑州大学第一附属医院综合 ICU 郑州 450052郑州大学第一附属医院综合 ICU 郑州 450052郑州大学第一附属医院综合 ICU 郑州 450052
医药卫生
宏基因组二代测序耐药基因肺炎克雷伯菌耐碳青霉烯
metagenomic next-generation sequencingdrug resistance genesKlebsiella pneumoniaecarbapenem resist-ance
《郑州大学学报（医学版）》 2026 (3)
169-172,4
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