Application of metagenomic next-generation sequencing in diagnosis of infectious diseases of central nervous system
SHANG GUAN Lijuan1,2, WANG Hailong1,2, SHANG Jing1,2, WANG Zhijun1,2, HOU Miaomiao1,2, XUE Lanping1,2
1. Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences Tongji Shanxi Hospital, the Third Hospital of Shanxi Medical University, Taiyuan 030032, China; 2. Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
Abstract：Objective To investigate the application value of metagenomic next-generation sequencing (mNGS) in the diagnosis of infectious diseases of central nervous system (CNS infectious diseases).Methods The clinical data of 85 patients with CNS infectious diseases admitted to the Neurology Department of Shanxi Bethune Hospital from January 2019 to December 2021 were retrospectively analyzed to explore the advantages of mNGS.Results Twenty-one kinds of pathogens were detected by mNGS, 57 cases were positive, 48 cases were in accordance with clinical diagnosis, 9 cases were not, and the accuracy was 56.5%(48/85); 23 cases were positive by traditional methods, 22 cases were in accordance with clinical diagnosis, 1 case was not, and the accuracy was 25.9%(22/85). The difference between the two methods was significant (P<0.05).Conclusions The detection accuracy of mNGS is higher than that of the traditional method, and mNGS can be used as a complementary method to the traditional detection one, but because of the results of mNGS are inconsistent with the clinical diagnosis in many cases, the interpretation of detection results should be carefully considered in combination with clinical practice.
Wilson M R, Naccache S N, Samayoa E, et al. Actionable diagnosis of neuroleptospirosis by next-generation sequencing[J]. N Engl J Med, 2014, 370(25): 2408-2417.
[2]
Li M H, Li Y J, Hu B, et al. Clinical characteristics and next generation sequencing of three cases of Listeria monocytogenes meningitis with complications[J]. Zhonghua Erke Zazhi, 2019, 57(8): 603-607.
Guan H, Shen A, Lv X, et al. Detection of virus in CSF from the cases with meningoencephalitis by next-generation sequencing[J]. J Neurovirol, 2016, 22(2): 240-245.
Wang S, Chen Y, Wang D, et al. The feasibility of metagenomic next-generation sequencing to identify pathogens causing tuberculous meningitis in cerebrospinal fluid[J]. Front Microbiol, 2019, 10: 1993.
[9]
Wilson M R, Sample H A, Zorn K C, et al. Clinical metagenomic sequencing for diagnosis of meningitis and encephalitis[J]. N Engl J Med, 2019, 380(24): 2327-2340.
Miao Q, Ma Y, Wang Q, et al. Microbiological diagnostic performance of metagenomic next-generation sequencing when applied to clinical practice[J]. Clin Infect Dis,2018, 67(suppl_2): S231-S240.
[12]
Zhang Y, Cui P, Zhang H C, et al. Clinical application and evaluation of metagenomic next-generation sequencing in suspected adult central nervous system infection[J]. J Transl Med, 2020, 18(1): 199.
[13]
Nigrovic L E, Malley R, Macias C G, et al. Effect of antibiotic pretreatment on cerebrospinal fluid profiles of children with bacterial meningitis[J]. Pediatrics,2008, 122(4): 726-730.
[14]
Fan S Y, Wang X, Hu Y, et al. Metagenomic next-generation sequencing of cerebrospinal fluid for the diagnosis of central nervous system infections: a multicentre prospective study[EB/OL]. (2019-06-10) .[2020-09-17].https://www.biorxiv.org/content/10.1101/658047v1.
[15]
Xing X W, Zhang J T, Ma Y B, et al. Metagenomic next-generation sequencing for diagnosis of infectious encephalitis and meningitis: a large, prospective case series of 213 patients[J]. Front Cell Infect Microbiol,2020, 10: 88.
Simner P J, Miller S, Carroll K C. Understanding the promises and hurdles of metagenomic next-generation sequencing as a diagnostic tool for infectious diseases[J]. Clin Infect Dis, 2018,66(5): 778-788.
2022, Vol. 33 
