宏基因组二代测序在脊柱感染诊疗中的应用与进展
The Role of Metagenomic Next-Generation Sequencing in Managing Spinal Infections: A Review of Applications and Recent Advances
摘要: 脊柱感染，如化脓性脊柱炎、脊柱结核和布氏杆菌性脊柱炎等，是骨科及感染科领域中一类预后不良、极具挑战性的疾病。传统的病原学诊断手段，如微生物培养和影像学检查因各种局限性延误精准治疗时机。近年来，宏基因组二代测序(mNGS)技术以其无偏倚、广覆盖、高灵敏度、快速响应以及无需预设病原体的革命性特点，正以前所未有的力量重塑脊柱感染的病原学诊断格局。本文旨在系统性地综述mNGS在脊柱感染中的应用进展，客观审视mNGS技术面临的诸多挑战，同时将展望其广阔发展前景。
Abstract: Spinal infections, including pyogenic spondylitis, spinal tuberculosis, and brucellar spondylitis, represent a group of highly challenging diseases in orthopedics and infectious diseases, often associated with poor prognoses. Conventional etiological diagnostic methods, such as microbial culture and imaging studies, are hindered by various limitations that can delay the timely initiation of precise treatment. In recent years, metagenomic next-generation sequencing (mNGS) has been revolutionizing the diagnostic landscape of spinal infections. With its revolutionary characteristics—being unbiased, providing broad pathogen coverage, high sensitivity, rapid turnaround time, and obviating the need for a priori pathogen suspicion—mNGS is reshaping the paradigm of etiological diagnosis. This review aims to systematically summarize the advancements in the application of mNGS for spinal infections, critically evaluate the challenges associated with this technology, and discuss its promising future prospects.
文章引用：兰钰, 王利元, 杜宇. 宏基因组二代测序在脊柱感染诊疗中的应用与进展[J]. 临床医学进展, 2026, 16(3): 3894-3901. https://doi.org/10.12677/acm.2026.1631199

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