基于纳米孔测序技术的291例肺结核患者合并细菌与真菌感染病原谱分析

doi:10.19871/j.cnki.xfcrbzz.2025.06.014

摘要/Abstract

摘要： 目的本研究旨在通过第三代纳米孔测序技术,分析肺结核患者合并细菌及真菌感染的病原谱分布特征,以期为肺结核合并感染的临床诊疗提供科学依据。方法研究纳入2021年11月至2024年8月在南宁市第四人民医院收治的291例肺结核患者,采用纳米孔测序技术进行病原谱检测,并分析其检出率、季节分布、年龄分布及样本类型分布的特征。结果细菌中占比前3位的致病菌分别为流感嗜血杆菌、产黑色素普雷沃菌和黏滑罗氏菌;真菌中占比前3位的致病菌分别为白念珠菌、烟曲霉、耶氏肺孢子菌和限制性马拉色菌（后两者并列）。细菌感染集中在春、夏季,上述3种细菌以及真菌中的烟曲霉在春季检出率显著高于夏季（P<0.05）。3种细菌在≤60岁年龄组中的检出率显著高于>60岁年龄组,白念珠菌在>60岁年龄组中检出率最高（P<0.05）。3种细菌在肺泡灌洗液中检出率显著高于穿刺组织、脓肿抽液/胸腔积液及脑脊液（P<0.05）。结论本研究明确了肺结核患者合并细菌及真菌感染的核心优势病原菌,细菌以流感嗜血杆菌、产黑色素普雷沃菌、黏滑罗氏菌为主要类型;真菌以白念珠菌、烟曲霉、耶氏肺孢子菌和限制性马拉色菌为主要类型。春、夏季为细菌感染高发期。≤60岁患者更易合并上述3种细菌感染,>60岁患者更易合并白念珠菌感染。上述3种细菌在肺泡灌洗液样本中的检出率显著高于穿刺组织、脓肿抽液/胸腔积液及脑脊液。

关键词: 纳米孔测序技术, 肺结核, 真菌, 细菌, 病原谱

Abstract: Objective This study aimed to delineate the pathogen-spectrum characteristics of bacterial and fungal co-infections in pulmonary tuberculosis (PTB) patients by means of third-generation nanopore sequencing,in order to provide scientific basis for the clinical diagnosis and treatment of PTB combined infection. Method A total of 291 PTB patients admitted to the Fourth People's Hospital of Nanning from November 2021 to August 2024 were enrolled. Nanopore sequencing was employed for pathogen profiling. SPSS 26.0 was used to analyse detection rates and seasonal, age- and sample-type distributions with the χ² test. Result The three most frequently detected bacteria were Haemophilus influenzae, Prevotella melaninogenica and Rothia mucilaginosa. Among fungi, Candida albicans, Aspergillus fumigatus, and Pneumocystis jirovecii/Malassezia restricta (tied) predominated. Bacterial infections peaked in spring and summer; the detection rates of the three leading bacteria and A. Fumigatus in spring were significantly higher than in summer (P<0.05). The three main bacteria were more common in patients≤60 years, whereas Candida albicans was more prevalent in those>60 years (P<0.05). Detection rates of the three bacteria in bronchoalveolar-lavage fluid were significantly higher than in puncture tissue, abscess/thoracic fluid or cerebrospinal fluid (P<0.05). Conclusion We identified the core dominant pathogens of bacterial and fungal co-infection in PTB patients.The main types of bacteria are Haemophilus influenzae, Prevotella melaninogenica, and Rothia mucilaginosa; the main types of fungi are Candida albicans, Aspergillus fumigatus, Pneumocystis jirovecii, and Malassezia restricta. Bacterial co-infections are most frequent in spring and summer. Patients aged≤60 years are more prone to the three leading bacterial infections, whereas those>60 years are more susceptible to Candida albicans. For these bacteria, bronchoalveolar-lavage fluid provides the highest detection yield.

Key words: Nanopore sequencing technology, Pulmonary tuberculosis, Fungi, Bacteria, Pathogen spectrum

中图分类号:

R515
521

朱庆东, 赵春艳, 黄爱春, 曾春梅, 李维文, 陈灿灵, 宋畅. 基于纳米孔测序技术的291例肺结核患者合并细菌与真菌感染病原谱分析[J]. 新发传染病电子杂志, 2025, 10(6): 87-92.

Zhu Qingdong, Zhao Chunyan, Huang Aichun, Zeng Chunmei, Li Weiwen, Chen Canling, Song Chang. Analysis of pathogen spectrum of bacterial and fungal coinfections in 291 pulmonary tuberculosis patients based on nanopore sequencing[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(6): 87-92.

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