Clinical metagenomic next-generation sequencing test for diagnosis of central nervous system infections in ICU: A multicenter retrospective study.

IF 4.3 2区医学 Q1 INFECTIOUS DISEASES

International Journal of Infectious Diseases Pub Date : 2025-09-30 DOI:10.1016/j.ijid.2025.108094

Jian Liu, Yongquan Dong, Yuanxiu Huang, Mengxiao Xie, Hongyu Wang, Qianqian Wang, Shengfeng Wang, Nan Wang, Yongpo Jiang, Wenxiao Zhang, Mingqiang Wang, Jian Chen, Lingtong Huang, Hongliu Cai

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引用次数: 0

Abstract

Background: Central nervous system (CNS) infections impose a substantial global burden of morbidity and mortality, necessitating accurate and timely diagnosis for optimal clinical management. Metagenomic next-generation sequencing (mNGS) has been demonstrated as a valuable tool for pathogen detection in patients with suspected CNS infections.

Methods: From December 2019 to June 2023, we conducted a comprehensive analysis of 520 cerebrospinal fluid samples collected from patients with suspected intracranial infections across six intensive care units. All pathogen-positive results identified through metagenomic next-generation sequencing were subsequently validated by an independent laboratory.

Results: Metagenomic NGS detected 105 microbial species in 520 clinical samples, comprising 64 bacterial species (61.0%), 16 DNA viruses (15.2%), 13 fungal species (12.4%), and 7 RNA viruses (6.7%). The 30-day mortality rate among all study participants was 18.5%. Metagenomic NGS identified 172 infection cases, whereas conventional culture methods detected only 31 cases. For CNS infections, mNGS demonstrated diagnostic sensitivity, specificity, and accuracy rates of 59%, 90.5%, and 72.5%, respectively.

Conclusions: Metagenomic NGS testing facilitates accelerated diagnosis of CNS infections and informs evidence-based clinical management decisions.

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临床宏基因组新一代测序检测诊断ICU中枢神经系统感染：一项多中心回顾性研究。

背景：中枢神经系统（CNS）感染是全球发病率和死亡率的重大负担，需要准确和及时的诊断以获得最佳的临床管理。新一代宏基因组测序（mNGS）已被证明是一种有价值的工具，用于检测疑似中枢神经系统感染患者的病原体。方法：2019年12月至2023年6月，对6个重症监护病房疑似颅内感染患者采集的520份脑脊液样本进行综合分析。所有通过新一代宏基因组测序确定的病原体阳性结果随后由独立实验室验证。结果：元基因组NGS在520份临床样本中检出105种微生物，其中细菌64种（61.0%），DNA病毒16种（15.2%），真菌13种（12.4%），RNA病毒7种（6.7%）。所有研究参与者的30天死亡率为18.5%。宏基因组NGS检测到172例感染病例，而传统培养方法仅检测到31例。对于中枢神经系统感染，mNGS的诊断敏感性、特异性和准确率分别为59%、90.5%和72.5%。结论：宏基因组NGS检测有助于加速中枢神经系统感染的诊断，并为循证临床管理决策提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Infectious Diseases 医学-传染病学

CiteScore

18.90

自引率

2.40%

发文量

1020

审稿时长

30 days

期刊介绍： International Journal of Infectious Diseases (IJID) Publisher: International Society for Infectious Diseases Publication Frequency: Monthly Type: Peer-reviewed, Open Access Scope: Publishes original clinical and laboratory-based research. Reports clinical trials, reviews, and some case reports. Focuses on epidemiology, clinical diagnosis, treatment, and control of infectious diseases. Emphasizes diseases common in under-resourced countries.