论著

肺泡灌洗液靶向高通量测序在鹦鹉热衣原体肺炎中的应用价值

Application of bronchoalveolar lavage fluid targeted next-generation sequencing in Chlamydia psittaci pneumonia

:459-465
 
       目的 探究肺泡灌洗液靶向高通量测序(tNGS)在鹦鹉热衣原体肺炎中应用效果。方法 选取2021年5月—2025年3月我院收治的35例鹦鹉热衣原体肺炎患者进行研究,患者均接受肺泡灌洗液tNGS检测、肺泡灌洗液常规病原检测,以病原学为金标准,分析肺泡灌洗液tNGS对鹦鹉热衣原体肺炎的诊断效能。结果 金标准对鹦鹉热衣原体阳性检出35例,检出率100.00%,肺泡灌洗液tNGS阳性检出率高于传统病原检测,检测结果回报耗时短于肺泡灌洗液传统病原检测(P<0.05)。结论 鹦鹉热衣原体肺炎临床症状缺乏特异性,容易转为重症肺炎,肺泡灌洗液tNGS可提高鹦鹉热衣原体肺炎检出率且结果回报较快,采用四环素类、喹诺酮类抗生素有助于改善患者预后。
     Objective To investigate the application effect of targeted next-generation sequencing(tNGS)of bronchoalveolar lavage fluid(BALF)in Chlamydia psittaci pneumonia.Methods Thirty-five patients with Chlamydia psittaci pneumonia admitted to our hospital from May 2021 to March 2025 were selected for the study.All patients underwent BALF tNGS and conventional BALF pathogen detection.With etiology as the gold standard,the diagnostic efficacy of BALF tNGS for Chlamydia psittaci pneumonia was analyzed.Results The gold standard detected 35 cases of Chlamydia psittaci positive,with a detection rate of 100.00%.The positive detection rate of tNGS in alveolar lavage fluid was higher than that of traditional pathogen detection,and the results report time of tNGS was shorter than that of traditional pathogen detection(P<0.05).Conclusions Chlamydia psittaci pneumonia lacks specificity in clinical symptoms and is easy to turn into severe pneumonia,bronchoalveolar lavage fluid tNGS can improve the detection rate of Chlamydia psittaci pneumonia and the results return quickly,and the use of tetracyclines and quinolones antibiotics can help improve the prognosis of patients.

论著

广州番禺地区鹦鹉热衣原体肺炎的临床特征及疗效分析

Clinical characteristics and treatment efficacy of Chlamydia psittaci pneumonia in Panyu district of Guangzhou

:1574-1580
 
        目的   分析广州番禺地区鹦鹉热衣原体肺炎患者临床表现、实验室及胸部CT特征、并发症以及治疗方案,为其临床诊治提供参考。方法   回顾性分析2022年1月—2024年7月在广州市番禺区何贤纪念医院通过二代测序技术确诊的10例鹦鹉热感染患者的临床资料。结果  5例(5/10)患者有明确的鸟类或禽类接触史,8例(8/10)患者以发热为首发症状,发热(10/10)、咳嗽、咳痰(10/10)、呼吸困难(7/10)、相对缓脉(8/10)是主要临床表现。患者白细胞计数通常正常或轻微升高;多数患者存在有不同程度的电解质紊乱(10/10)及肝功能损伤(8/10)、乳酸脱氢酶升高(8/10),白蛋白显著降低(8/10)和C反应蛋白显著升高(10/10)。最常见的胸部CT异常为多肺叶受累的斑片状或片状实变,而重症患者多合并双侧胸腔积液。大多数患者经四环素或喹诺酮类单用,或者四环素联用β-内酰胺类抗菌药物治疗,预后良好。结论   有鸟类或禽类接触史、以发热为首发或主要症状、存在相对缓脉、白细胞计数升高不明显等临床特征可有助于区分鹦鹉热衣原体肺炎与其他传统细菌性肺炎,但这并不能确诊。二代测序技术是确诊鹦鹉热衣原体感染的很好方法,可以缩短诊断延误时间并改善患者预后。
       Objective  To describe the clinical,laboratory and chest CT characteristics as well as the complications and treatments of Chlamydia psittaci pneumonia patients in Panyu district of Guangzhou,to provide  reference for clinical diagnosis and treatment.Methods  A retrospective study was conducted on the clinical characteristics of Chlamydia psittaci pneumonia patients who were diagnosed by next-generation sequencing in Panyu Hexian Memorial Hospital of Guangzhou form January 2022 to July 2024.Results  Half patients had a definite history of bird or poultry exposure.Fever(100%),cough,sputum(100%),dyspnea(70%),relative bradycardia(80%)were the main clinical presentation.The total white cell counts were usually normal or slightly increased.Most patients had electrolyte disturbance(100%),liver function impairment(80%),lactic dehydrogenase increased(80%),albumin decreased(80%)and C reactive protein increased remarkably(100%).The most common chest CT abnormality was patchy or flaky hyper densities and consolidation,bilateral pleural effusion was common in severe patients.All patient exhibited good recovery after being treated with tetracycline or quinolone alone,or tetracycline in combination with other antibiotics.Conclusions  These characteristics may help distinguish Chlamydia psittaci pneumonia from other traditional bacterial pneumonia,but they are not definitive.Next-generation sequencing may be a promising approach to confirm Chlamydia psittaciinfection,which can shorten the diagnostic delay time and improve the prognosis of patients.
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