脑脊液宏基因组二代测序对临床高度疑似颅内感染病原学诊断的价值

Value of the Metagenomic Next-generation Sequencing of Cerebrospinal Fluid Acer in the Etiological Diagnosis of Highly Suspected Intracranial Infection

目的探讨脑脊液宏基因组二代测序(mNGS)技术对临床高度疑似颅内感染病原学诊断的价值。方法回顾性分析2021年9月1日至2022年10月31日就诊于郑州大学第一附属医院急诊重症监护室的30例高度疑似颅内感染患者的病例资料,共留取脑脊液mNGS标本30例,同时进行微生物培养。采集患者病史、体征、实验室及辅助检查结果。分析脑脊液mNGS技术对高度疑似颅内感染病原学诊断的价值。结果脑脊液mNGS总体检测阳性率(43.33%)高于常规培养法(10.00%),mNGS检测时间中位数(36.3 h)低于常规培养(104.2 h),差异有统计学意义(P<0.05)。mNGS对总体颅内感染特异度为76.92%,灵敏度为58.82%;常规培养对颅内感染特异度为100.00%,灵敏度为17.65%,mNGS对颅内感染预测的灵敏度较常规培养高,且其对于颅内感染的诊断价值较高。结论mNGS能够快速检测脑脊液感染病原体,可为临床早期精准治疗提供重要的病原学依据,且具有较高的诊断价值。

Objective To explore the value of metagenomic next-generation sequencing(mNGS)of cerebrospinal fluid for etiological diagnosis of highly suspected intracranial infection.Methods The case data of 30 patients with highly suspected intracranial infection admitted to the Emergency Intensive Care Unit of the First Affiliated Hospital of Zhengzhou University from September 1,2021 to October 31,2022 were retrospectively analyzed.A total of 30 cerebrospinal fluid mNGS samples were collected,and simultaneously cultured with microorganisms.Patients’medical history,signs,laboratory and auxiliary examination results were collected.The value of mNGS of cerebrospinal fluid for etiological diagnosis of highly suspected intracranial infection was analyzed.Results The overall positive rate of mNGS in cerebrospinal fluid(43.33%)was higher than that in conventional culture(100.00%),and the median detection time of mNGS(36.3 h)was significantly lower than that in conventional culture(104.2 h),and the difference was statistically significant(P<0.05).The specificity and sensitivity of mNGS for intracranial infection were 76.92%and 58.82%.The specificity and sensitivity of conventional culture for intracranial infection were 100.00%and 17.65%.The sensitivity of mNGS for predicting intracranial infection was higher than that of conventional culture,and its diagnostic value for intracranial infection was higher.Conclusion mNGS can rapidly detect pathogens of cerebrospinal fluid infection,which can provide important etiological basis for early clinical accurate treatment,and has high diagnostic value.