Clinical application and evaluation of metagenomic next-generation sequencing in suspected adult central nervous system infection.

Clinical application and evaluation of metagenomic next-generation sequencing in suspected adult central nervous system infection.

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accurate etiologic diagnosis is essential for infection of the central nervous system (CNS infections). The diagnostic value of metagenomic sequencing generation (mNGS), a powerful platform that appears, remains to be studied in the CNS infections.We conduct a prospective cohort study comparing single-center for mNGS with conventional methods including culture, smear and others 248 suspected CNS infectious patients were enrolled and clinical data were recorded. RESULTS mNGS reported a sensitivity of 90.00% (9/10) in patients with culture-positive without empirical treatment and 66.67% (6/9) in patients treated empirically. Detected addition of 48 bacteria and fungi in culture-negative patients, mNGS provide higher detection rate compared with culture in patients with (34.45% vs. 7.56%, McNemar test, p 0.0083). Compared with the conventional method, the positive percent agreement and negative percent agreement was 75.00% and 69.11% separately. mNGS detection rate was significantly higher in patients with cerebrospinal fluid (CSF) WBC> 300 * 106 / L, CSF protein> 500 mg / L or glucose ratio ≤ 0.3. mNGS sequencing reads correlated with CSF WBC, the ratio of glucose and the development of clinical disease. mNGS showed satisfactory diagnostic performance in CNS infections and has a superior detection rate overall culture. mNGS probably held diagnostic benefit, especially in patients treated empirically. CSF laboratory results are statistically relevant mNGS detection rate, and mNGS can dynamically monitor the progression of the disease.

accurate etiologic diagnosis is essential for infection of the central nervous system (CNS infections). The diagnostic value of metagenomic sequencing generation (mNGS), a powerful platform that appears, remains to be studied in the CNS infections. We conduct a prospective cohort study comparing single-center for mNGS with conventional methods including culture, smear and others 248 suspected … Read more