Objectives: This study aimed to compare and analyze the consistency and difference between metageno-mic next-generation sequencing (mNGS) and conventional bacterial culture in the detection of pathogenic microorganisms in maxillofacial space infection, as well as to provide a new detection method for the early clinical identification of pathogenic bacteria in maxillofacial space infection.
Methods: The clinical data of 16 patients with oral and maxillofacial space infections in the First Affiliated Hospital of Zhengzhou University from March 2020 to June 2020 were collected. mNGS and conventional bacterial culture methods were used to detect pus. We then analyzed and compared the test results of the two methods, including the test cycle, positive detection rate, anaerobic bacteria, facultative anaerobes and aerobic bacteria detection rates, distribution of pathogenic bacteria, relative species abundance, and resistance genes.
Results: The average inspection period of mNGS was (18.81±3.73) h, and the average inspection period of bacterial culture was (83.25±11.64) h, the former was shorter than the latter (P<0.05). The positive detection rate of mNGS was 100% (16/16), and the positive detection rate of conventional bacterial culture was 31.25% (5/16), the former was higher than the latter (P<0.05). The detection rate of mNGS anaerobic bacteria was 93.75% (15/16), the detection rate of bacterial culture anaerobes was 0 (0/16), the former was higher than the latter (P<0.05). Using mNGS, the detection rate of facultative anaerobes in bacterial culture was 75.00% (12/16), and the detection rate of facultative anaerobes in bacterial culture was 25.00% (4/16), the former was higher than the latter (P<0.05). The detection rate of aerobic bacteria in bacterial culture was 12.50% (1/16), the former was higher than the latter (P>0.05). mNGS detected 15 kinds of pathogenic bacteria, among which 3 were Gram positive, 12 were Gram negative, 49 were non-pathogenic, 16 were Gram positive, and 32 were Gram negative, 1 was fungus.
Conclusions: Compared with conventional bacterial culture, mNGS has the characteristics of short test time, high sensitivity, and high accuracy. Thus, it is a new detection method for the early identification of pathogenic bacteria in maxillofacial space infection and is beneficial to the early clinical diagnosis and treatment of the disease.
目的: 对比分析宏基因组测序（mNGS）与常规细菌培养在检测颌面部间隙感染致病微生物方面的差异与一致性，为临床早期明确颌面部间隙感染致病菌提供新的检测方法。方法: 收集2020年3—6月就诊于郑州大学第一附属医院的16例口腔颌面部间隙感染患者的临床资料，分别使用mNGS及常规细菌培养方法对脓液进行检测，对两种方法的检验结果进行分析比较，包括检验周期、阳性检出率、厌氧菌、兼性厌氧菌及需氧菌检出率、病原菌分布、相对物种丰度、耐药基因。结果: mNGS平均检验周期为（18.81±3.73）h，细菌培养的平均检验周期为（83.25±11.64）h，前者短于后者（P<0.05）。mNGS的阳性检出率100%（16/16），常规细菌培养的阳性检出率31.25%（5/16），前者高于后者（P<0.05）。mNGS厌氧菌检出率为93.75%（15/16），细菌培养厌氧菌检出率为0（0/16），前者高于后者（P<0.05）；mNGS的兼性厌氧菌检出率为75.00%（12/16），细菌培养的兼性厌氧菌检出率为25.00%（4/16），前者高于后者（P<0.05）；mNGS的需氧菌检出率为25.00%（4/16），细菌培养的需氧菌检出率为12.50%（1/16），前者高于后者（P>0.05）。在mNGS检测出的15种致病菌中，3种为革兰阳性菌，12种为革兰阴性菌；49种非致病菌中，16种为革兰阳性菌，32种为革兰阴性菌，1种为真菌。结论: 与常规细菌培养相比，mNGS具有检验时间短、灵敏度高、准确率高的特点，为临床上早期明确颌面间隙感染致病菌提供新的检测方法，并有利于该疾病的早期临床诊断与治疗。.
Keywords: maxillofacial space infection; metagenomic next-generation sequencing; next-generation sequencing technology; pathogenic microorga-nism.