Etiological diagnostic value of cerebrospinal fluid metagenomic next-generation sequencing in central nervous system infection
10.3760/cma.j.issn.1671-0282.2022.04.008
- VernacularTitle:脑脊液二代测序在中枢神经系统感染中的病原学诊断价值
- Author:
Cuicui MENG
1
;
Ding YUAN
;
Yanwu YU
;
Jinzhu WANG
;
Jianjun GUO
;
Guiying ZHU
;
Yimeng WEI
;
Jihong CHEN
;
Leilei ZHANG
;
Yanxia GAO
Author Information
1. 郑州大学第一附属医院郑东院区急救中心,郑州 450000
- Keywords:
Central nervous system infection;
mNGS;
Conventional methods;
Pathogenic microorganism
- From:
Chinese Journal of Emergency Medicine
2022;31(4):471-476
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the etiological diagnostic value of metagenomic sequencing in central nervous system (CNS) infectious diseases.Methods:A total of 170 patients with central nervous system infection admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2020 were selected as the study subjects according to inclusion and exclusion criteria. General clinical data and pathogen test results were collected. All included patients underwent routine examination and mNGS test, and were divided into the conventional method test group and mNGS test group according to the test results. The measurement data conforming to normal distribution were represented by ± s; The measurement data that did not conform to normal distribution were represented by median and interquartile range. The classification data were expressed by the number of cases and percentage( n,%), and were compared by χ2 test or Fisher's exact test. Consistency test was represented by Kappa value. The detection of pathogenic microorganisms by the two methods and the rule of pathogen spectrum were compared and analyzed. Results:The overall positive rate of mNGS in CNS infectious diseases was higher than that of conventional methods (58.23% vs. 18.82%), and the difference was statistically significant ( P<0.01). Among the 20 samples which were both positive by the two methods, 10 cases were completely pathogenic, 5 cases were partially consistent and 5 cases were completely inconsistent. In the detection of tuberculous nervous system infection, the positive rates were 66.7%, 53.8%, 44.0%, 40.0%, 4.0% in blood T-SPOT, cerebrospinal fluid mNGS, ADA, Mycobacterium tuberculosis DNA and tuberculous specific antibody, respectively. The positive rate of acid-fast staining was 0. The positive rate of mNGS combined with conventional method was 80.8%. Conclusions:The detection rate of mNGS in CNS infection is better than that of conventional methods. However, it does not show obvious superiority in the detection rate of Mycobacterium tuberculosis associated nervous system infection. In general, mNGS detection of pathogenic bacteria is more extensive, which is conducive to a thorough and comprehensive understanding of the bacterial characteristics of central nervous system infection. The combination of the two methods can make up for the deficiency of clinical routine detection to a certain extent, and can maximize the detection rate.
