宏基因组新一代测序对感染的临床价值

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-09-09 DOI:10.1515/biol-2022-0938

Benfa Han, Xiaoli Zhang, Xiuxi Li, Mei Chen, Yanlin Ma, Yunxia Zhang, Song Huo

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引用次数: 0

摘要

颅内感染（ICI）是神经外科手术后常见的严重并发症。宏基因组新一代测序（mNGS）技术可为颅内感染的临床诊断和治疗提供参考。本研究旨在探讨 mNGS 技术在分析人类免疫缺陷病毒（HIV）感染与神经外科手术后 ICI 的临床特征方面的应用价值。所有患者均接受了常规脑脊液分析和传统病原体检测，然后进行了 mNGS 基因组分析。以 ICI 的临床诊断为金标准，计算了两种检测方法的敏感性、特异性、阳性预测值和阴性预测值。构建了接收者操作特征曲线来评估曲线下面积（AUC），以评价 mNGS 在疑似颅内感染性病原体诊断中的临床价值。结果显示，mNGS 的阳性率为 71.67%（43 例），而传统病原体检测方法的阳性率为 28.33%（17 例），差异显著（P < 0.05）。mNGS 检测 ICI 的灵敏度为 83.7%，显著高于传统方法的 34.88%（P <0.05）。mNGS 的病原体检出率高于传统方法（P = 0.002），其 AUC 为 0.856（95% CI：0.638-0.967），明显高于传统方法的 AUC 0.572（95% CI：0.350-0.mNGS 成功鉴定了与 ICI 相关的微生物，如隐球菌、丙酸杆菌、葡萄球菌、棒状杆菌、微球菌和念珠菌。这些发现强调了 mNGS 技术在分析 HIV 感染特征和神经外科手术后 ICI 方面的临床适用性。这项技术能更准确地诊断和治疗 ICI，为制定有效的治疗策略提供宝贵的见解。

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Clinical value of macrogenome next-generation sequencing on infections

Intracranial infection (ICI) is a frequent and serious complication after neurosurgery. Macrogenome next-generation sequencing (mNGS) technology can provide reference for clinical diagnosis and treatment of ICI. This work aimed to explore the application value of mNGS technology in analyzing the clinical characteristics of human immunodeficiency virus (HIV) infection and ICI after neurosurgery. A total of 60 patients with ICI were enrolled as the research objects, all patients underwent routine cerebrospinal fluid analysis and traditional pathogen detection, followed by mNGS genome analysis. Using clinical diagnosis of ICI as the gold standard, the sensitivity, specificity, positive predictive value, and negative predictive value for both detection methods were calculated. Receiver operating characteristic curves were constructed to assess the area under the curve (AUC) for evaluating the clinical value of mNGS in suspected intracranial infectious pathogen diagnosis. Results showed a positivity rate of 71.67% (43 cases) with mNGS compared to 28.33% (17 cases) with traditional pathogen detection methods, demonstrating a significant difference (P < 0.05). The sensitivity of mNGS for detecting ICIs was 83.7%, significantly higher than the 34.88% observed with traditional methods (P < 0.05). The pathogen detection rate of mNGS was higher than traditional methods (P = 0.002), with an AUC of 0.856 (95% CI: 0.638–0.967), significantly greater than the AUC of 0.572 (95% CI: 0.350–0.792) for traditional methods (P < 0.05). mNGS successfully identified microorganisms such as Cryptococcus, Propionibacterium, Staphylococcus, Corynebacterium, Micrococcus, and Candida associated with ICIs. These findings underscore the clinical applicability of mNGS technology in analyzing the characteristics of HIV infection and ICI post-neurosurgical procedures. This technology enables more accurate diagnosis and treatment of ICIs, providing valuable insights for developing effective therapeutic strategies.

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.