Application of tNGS in Diagnosis and Treatment of Mycoplasma pneumoniae Pneumonia in Children
10.3870/j.issn.1672-0741.24.05.020
- VernacularTitle:tNGS在儿童肺炎支原体肺炎诊治中的应用
- Author:
Dong XU
1
;
Sainan SHU
1
;
Xiaoping LUO
1
Author Information
1. 华中科技大学同济医学院附属同济医院儿科,武汉 430030
- Publication Type:Journal Article
- Keywords:
Mycoplasma pneumoniae;
targeted next-generation sequencing test;
drug-resistant gene
- From:
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
2025;54(1):95-100
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the application of targeted next-generation sequencing test(tNGS)in detecting patho-gens and drug resistance genes in the diagnosis and treatment of Mycoplasma pneumoniae pneumonia(MPP)in chil-dren.Methods The clinical data of children diagnosed with MPP and hospitalized in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from July 2022 to December 2023 were analyzed.The differences of MP se-quence detected by tNGS in children of different gender,age,course,and clinical features were compared.The performance of tNGS in detecting macrolides resistance genes was assessed.The optimal prediction cut-off value of MP resistance gene was ex-plored by ROC.Results A total of 497 cases were included,including 257(51.7％)male and 240(48.3％)female.The age dis-tribution was from 3 months to 13 years old[(6.08±2.68)years old in average],and the average durations of fever and cough were(6.04±3.42)and(7.46±5.54)days,respectively.MP was detected in all patients by tNGS method.There was no signifi-cant difference in different gender or age groups.The MP sequence count in patients with positive nucleic acid was significantly higher than that in patients with negative nucleic acid.The MP sequence count in lower respiratory specimens was significantly higher than that in upper respiratory specimens.MP sequence count in severe cases was significantly higher than that in non-se-vere cases,but there was no significant difference between patients with or without pulmonary complications and refractory or non-refractory cases.The overall diagnostic sensitivity of tNGS for detecting MP drug-resistant genes was 92.8％,specificity was 27.8％,PPV was 48.3％,NPV was 84.2％,and the mutation site was 23S rRNA:A2063G.The ratio of MP pathogenic se-quence to drug-resistant gene sequence was 6.83,which was the best cut-off value for predicting drug resistance.The negative predictive value was higher when the MP pathogenic sequence ratio was greater than 6.83.Conclusion tNGS has the value in early diagnosis of MPP.The MP sequence counts may have a guiding value in predicting disease severity.The negative predictive value is higher in drug-resistant gene detection.
