The application value of mNGS in the diagnosis of suspected central nervous system infection
10.19405/j.cnki.issn1000-1492.2023.09.024
- Author:
Xiaolan Gao
1
;
Yu Yang
2
;
Qing Mei
1
;
Aijun Pan
1
Author Information
1. Dept of Critical Care Medicine , The First Afiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital) , Hefei 230001
2. Provincial Hospital afiliated of Anhui Medical University,Hefei 230001
- Publication Type:Journal Article
- Keywords:
metagenomic next⁃generation sequencing;
cerebrospinal fluid;
central nervous system infection;
general intensive care unit
- From:
Acta Universitatis Medicinalis Anhui
2023;58(9):1584-1588
- CountryChina
- Language:Chinese
-
Abstract:
Objective :To explore the application value of metagenomic second⁃generation sequencing ( mNGS) in patients with suspected central nervous system ( CNS) infection in the general intensive care unit ( ICU) , and to
provide reference for rapid and accurate diagnosis of central nervous system infection patients in the general ICU.
Methods :The data of 82 patients who underwent cerebrospinal fluid mNGS examination in the general ICU of our
hospital from 2018 to 2021 were collected. According to the inclusion criteria , 52 patients with suspected CNS infection , who had undergone routine biochemical and culture testing as well as mNGS on cerebrospinal fluid samples , were included in the final data analysis. The clinical diagnosis of CNS infection was taken as the " gold standard" , and the application value of the two methods , traditional culture and mNGS , for clinical diagnosis were compared.
Results :Among the 52 patients , 32 were finally diagnosed with CNS infection , 24 of them were positive for
mNGS in cerebrospinal fluid , and 5 were positive in culture of cerebrospinal fluid. The sensitivity and specificity of the two methods were 75. 00% vs 15. 63% and 55. 00% vs 95. 00% , The negative predictive values were 72. 73% vs 83. 33% , and 57. 89% vs 41. 00% , respectively; there was no significant difference in the detection rates between the two methods (P > 0. 05) . Of the 32 patients with CNS infection , 14 had bacterial infection , 9 had viral infection , 2 had fungal infection and 7 had other pathogenic bacteria infection. The sensitivity of mNGS to detect pathogens of viral infection was 66. 70% , the specificity was 95. 30% , and the positive predictive value was 75. 00% , and the negative predictive value was 93. 20% , which was highly consistent with the gold standard of clinical final diagnosis (Kappa value = 0. 649 , P < 0. 01) .
Conclusion : Cerebrospinal fluid mNGS has a higher diagnostic accuracy for central viral infection compared to bacterial infection , and it is recommended to use mNGS for rapid screening of patients with suspected central virus infection.
- Full text:2024081409554751959mNGS在疑似中枢神经系统感染诊断中的应用价值_高晓览.pdf
