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Development and evaluation of a culture-free microbiota profiling platform (MYcrobiota) for clinical diagnostics

机译:开发和评估用于临床诊断的无培养菌群分析平台(MYcrobiota)

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摘要

Microbiota profiling has the potential to greatly impact on routine clinical diagnostics by detecting DNA derived from live, fastidious, and dead bacterial cells present within clinical samples. Such results could potentially be used to benefit patients by influencing antibiotic prescribing practices or to generate new classical-based diagnostic methods, e.g., culture or PCR. However, technical flaws in 16S rRNA gene next-generation sequencing (NGS) protocols, together with the requirement for access to bioinformatics, currently hinder the introduction of microbiota analysis into clinical diagnostics. Here, we report on the development and evaluation of an “end-to-end” microbiota profiling platform (MYcrobiota), which combines our previously validated micelle PCR/NGS (micPCR/NGS) methodology with an easy-to-use, dedicated bioinformatics pipeline. The newly designed bioinformatics pipeline processes micPCR/NGS data automatically and summarizes the results in interactive, but simple web reports. In order to explore the utility of MYcrobiota in clinical diagnostics, 47 clinical samples (40 “damaged skin” samples and 7 synovial fluids) were investigated using routine bacterial culture as comparator. MYcrobiota confirmed the presence of bacterial DNA in 37/37 culture-positive samples and detected bacterial taxa in 2/10 culture-negative samples. Moreover, 36/38 potentially relevant aerobic bacterial taxa and 3/3 mixtures of anaerobic bacteria were identified using culture and MYcrobiota, with the sensitivity and specificity being 95%. Interestingly, the majority of the 448 bacterial taxa identified using MYcrobiota were not identified using culture, which could potentially have an impact on clinical decision-making. Taken together, the development of MYcrobiota is a promising step towards the introduction of microbiota analysis into clinical diagnostic laboratories.
机译:通过检测源自临床样品内存在的活细菌细胞和细菌细胞的DNA,微生物群分析有可能对常规临床诊断产生重大影响。这样的结果可以潜在地用于通过影响抗生素处方实践而使患者受益,或者产生基于经典的新诊断方法,例如培养或PCR。但是,16S rRNA基因下一代测序(NGS)协议中的技术缺陷,以及对获取生物信息学的要求,目前阻碍了将微生物群分析引入临床诊断。在这里,我们报告“端到端”微生物群分析平台(MYcrobiota)的开发和评估,该平台将我们先前验证的胶束PCR / NGS(micPCR / NGS)方法与易于使用的专用生物信息学相结合管道。新设计的生物信息学管道可自动处理micPCR / NGS数据,并在交互式但简单的Web报告中总结结果。为了探索霉菌菌群在临床诊断中的实用性,使用常规细菌培养作为比较剂,调查了47个临床样品(40个“受损皮肤”样品和7个滑液)。 MYcrobiota确认37/37培养阳性样品中存在细菌DNA,并在2/10培养阴性样品中检测到细菌类群。此外,使用培养物和霉菌鉴定出36/38种潜在相关的需氧细菌类群和3/3种厌氧细菌混合物,其敏感性和特异性为95%。有趣的是,使用霉菌菌群鉴定出的448种细菌类群中的大多数并未通过培养鉴定出来,这可能会对临床决策产生影响。综上所述,霉菌群的发展是朝着将微生物群分析引入临床诊断实验室迈出的有希望的一步。

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