ABSTRACT
OBJECTIVES@#To investigate the clinical application of metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) in the etiological diagnosis and treatment of refractory pneumonia (RTP) in children.@*METHODS@#A retrospective analysis was performed on 160 children with RTP who were admitted to the Department of Pediatric Internal Medicine, Maternal and Child Health Hospital of Inner Mongolia Autonomous Region, from January 2020 to March 2023. According to whether mNGS was performed, they were divided into two groups: mNGS (n=80) and traditional testing (n=80). All children received the tests of inflammatory markers and pathogen tests after admission. Traditional pathogenicity tests included microbial culture (sputum specimen collected by suction tube), nucleic acid detection of respiratory pathogens, and serological test (mycoplasma, tuberculosis, and fungi). For the mNGS group, BALF specimens were collected after bronchoscopy and were sent to the laboratory for mNGS and microbial culture. The two groups were analyzed and compared in terms of the detection of pathogens and treatment.@*RESULTS@#Compared with the traditional testing group, the mNGS group had a significantly higher detection rate of pathogens (92% vs 58%, P<0.05), with more types of pathogens and a higher diagnostic rate of mixed infections. Compared with the traditional testing group, the mNGS group had a significantly higher treatment response rate and a significantly lower incidence rate of complications during hospitalization (P<0.05). Treatment was adjusted for 68 children in the mNGS group according to the results of mNGS, with a treatment response rate of 96% (65/68) after adjustment.@*CONCLUSIONS@#Compared with traditional pathogen tests, BALF mNGS can significantly improve the detection rate of pathogens and find some rare pathogens. In clinical practice, when encountering bottlenecks during the diagnosis and treatment of children with RTP, it is advisable to promptly perform the mNGS to identify the pathogens.
Subject(s)
Humans , Child , Bronchoalveolar Lavage Fluid , Retrospective Studies , Pneumonia/therapy , High-Throughput Nucleotide Sequencing , Bronchoscopy , Sensitivity and SpecificityABSTRACT
We sought to compare the level of peripheral blood gamma interferon(IFN-γ),interleukin 4 (IL-4),TGF-β1,IL-10 and IFN-γ/IL-4 between acute brucellosis and chronic brucellosis to look for biochemical markers for chronic brucellosis.A total of 42 acute brucellosis and 42 chronic brucellosis cases were selected randomly from the Endemic Disease Prevention and Control Center of Ulanqab City as the research subjects with 20 local healthy persons as healthy control.Comparisons of IFN-γ,IL-4,TGF-β1,IL-10 and IFN-7/IL-4 in the three groups were tested by One-Way ANOVA analysis.Parameters of IL-4,IFN-γ,TGF-β1,IL-10 and IFN-γ/IL-4 in peripheral blood were analyzed with T-test between acute brucellosis with chronic brucellosis.Results showed that the mean of IFN-,IL-4,TGF-β1 and IFN-γ/IL-4 was significant difference in the three groups(F =6.86,11.90,12.25,4.60,P＜0.01),but not of IL-10(F=2.72,P＞0.05).The mean of IFN-γ,IL-4 andIFN-7/IL-4 was significant difference between acute brucellosis with chronic group(t=-1.99,82,-3.3,P＜0.05),but not of TGF-β1 and IL-10(t=-1.90,-1.81,P＞0.05).Combined with TGF-β1 and IL-10 levels,high level IFN-γ may be regarded as one of the biochemical markers for chronic brucellosis.
ABSTRACT
Objective To investigate the epidemiological characteristics of human brucellosis in Ulanqab of Inner Mongolia.Methods Three hundred and twenty patients with suspected brucellosis were selected,who had registered in the Ulanqab Center for Endemic Disease Control of Inner Mongolia from April to June 2011.The investigation covered general situation,such as gender,age,occupation and main clinical symptoms and so on.Blood samples were collected,and Rose Bengal plate agglutination test(RBPT) was used for serum screening.Those who were tested positive in RBPT were confirmed with tube agglutination test (SAT).Brucellosis was diagnosed according to Diagnostic criteria for Brucellosis (WS 269-2007).Data were analyzed with statistical software(SPSS 17.0).Results One hundred and thirty-four cases were positive in RBPT of the 320 people surveyed,of which 93 cases were positive in SAT; antibody titers were higher than 1 ∶ 100(++),therefore they were diagnosed as brucellosis,and the ratio was 29.1％(93/320).The number of patients with suspected brucellosis who were negative in SAT test was 41,and the ratio was 12.8％ (41/320).Among the 93 people who were infected,the constituent ratio of farmers and herdsmen who engaged in livestock was the highest,accounted for 63.4％(59/93) and 24.7％ (23/93) of the total number of patients ; infection rate of male (30.9％,55/178) was higher than that of females (26.7％,38/142) ; the number(39) of brucellosis patients who were over the age of 51 was the highest,and the ratio is 42.0％.The onset season mainly in May and August; main route of exposure was bare hands lambing,midwifery and contact with infected sheep pollutants.Conclusions Sheep is the main source of human Brucella infection in Ulanqab.It is the key to control the spreading of brucellosis through improving awareness of disease prevention among farmers and herdsmen as well intensifying the prevention and control of Brucella infection between livestock.
ABSTRACT
Objective To evaluate the effect of multiplex polymerase chain reaction(Multiple-PCR) in identification of Brucella strains.Methods Six standard Brucella strains (Brucella abortus,Brucella melitensis,Brucella suis,Brucella canis,Brucella ovis,Brucella neotomae) were used as positive controls and Escherichia coli O∶157 and Yersinia enterocolitica O∶9 were used as negative controls.A total of 29 Brucella strains were tested.Brucella strains were amplified by BCSP31-PCR and the species of Brucella with positive results were identified with Multiple-PCR method.Results The results of all 29 amplified Brucella strains were positive with BCSP31-PCR.The identified results of all Brucella strains were positive with Multiple-PCR,including 20 strains of Brucella melitensis,5 isolates of Brucella suis,3 strains of Brucella abortus and 1 strain of Brucella canis.Conclusion Multiple-PCR method is a rapid,specific,simple and low risk method for identification of Brucella species.