新一代宏基因组测序在中枢神经系统感染中的附加价值:对病例报告的系统回顾。

IF 5.4 2区 医学 Q1 INFECTIOUS DISEASES
Kira Waagner Birkeland, Laurence Mostert, Eric C J Claas, Hege Vangstein Aamot, Thomas Demuyser
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引用次数: 0

摘要

背景:引起中枢神经系统(CNS)感染的病原体的多样性提出了诊断挑战。患者的人口统计和地理位置影响某些病原体引起感染的可能性。目前的诊断方法依赖于劳动密集型培养或靶向检测。元基因组新一代测序(mNGS)是一种很有前途的检测CNS感染病原体的工具,提供了一种公正的方法。为了加强我们对患者人口统计学和通过mNGS确定的病原体范围的理解,我们对病例报告进行了系统的回顾。方法:于2024年3月检索PubMed数据库。2014年1月至2024年2月发表的CNS感染和mNGS病例报告基于预定义标准纳入。结果:检索到649篇文章,其中76篇被纳入,涉及104例患者。大多数患者为男性(75%),中位年龄为31.5岁[0-75],28%的患者免疫功能低下。最常见的诊断是脑炎(36%),其次是脑膜炎(23%)和脑膜脑炎(22%)。鉴定出53种独特的病原体,包括27种不同的病毒、19种细菌、5种寄生虫和2种真菌。综合征性脑炎/脑膜炎小组只能检测到四种病毒和五种细菌。此外,14种细菌被认为生长缓慢或挑剔,可能很难通过培养来检测。结论:应用mNGS诊断中枢神经系统感染,揭示了导致这些严重感染的病原体的多样性,从而提高了诊断水平,便于靶向治疗。虽然病例报告可能存在偏倚,但它们为在这种临床背景下使用mNGS提供了有价值的见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The added value of metagenomic next-generation sequencing in central nervous system infections: a systematic review of case reports.

Background: The diversity of pathogens causing central nervous system (CNS) infections presents a diagnostic challenge. Patient demographics and geographical location affect the likelihood of certain pathogens causing infection. Current diagnostic methods rely on labour-intensive cultivation or targeted detection. Metagenomic next-generation sequencing (mNGS) is a promising tool for detecting pathogens in CNS infections, offering an unbiased approach. To enhance our understanding of patient demographics and the range of pathogens identified through mNGS, we conducted a systematic review of case reports.

Methods: The PubMed database was searched in March 2024. Case reports on CNS infections and mNGS published from January 2014 through February 2024 were included based on predefined criteria.

Results: The search yielded 649 articles, of which 76 were included, encompassing 104 patients. Most patients were male (75%), the median age was 31,5 years [0-75] and 28% were immunocompromised. The most common diagnosis was encephalitis (36%), followed by meningitis (23%) and meningoencephalitis (22%). 53 unique pathogens were identified, comprising 27 different viruses, 19 bacteria, 5 parasites, and 2 fungi. Syndromic encephalitis/meningitis panels would only have detected four of the viruses and five of the bacteria. Additionally, 14 of the bacterial species are considered slow-growing or fastidious and could be challenging to detect by culture.

Conclusion: The application of mNGS in diagnosing CNS infections reveals the diversity of pathogens responsible for these severe infections, thereby improving diagnostics and facilitating targeted treatment. While case reports may be subjected to bias, they provide valuable insights into the use of mNGS in this clinical context.

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来源期刊
Infection
Infection 医学-传染病学
CiteScore
12.50
自引率
1.30%
发文量
224
审稿时长
6-12 weeks
期刊介绍: Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.
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