Chen YY, Guo Y, Xue XH, Pang F. Application of metagenomic next-generation sequencing in the diagnosis of infectious diseases of the central nervous system after empirical treatment. World J Clin Cases 2022; 10(22): 7760-7771 [PMID: 36158512 DOI: 10.12998/wjcc.v10.i22.7760]
Corresponding Author of This Article
Ying-Ying Chen, PhD, Additional Professor, Department of Neurology, Liaocheng People's Hospital, No. 67 Dongchang West Road, Liaocheng 252000, Shandong Province, China. chen323232azqiqi@163.com
Research Domain of This Article
Clinical Neurology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 6, 2022; 10(22): 7760-7771 Published online Aug 6, 2022. doi: 10.12998/wjcc.v10.i22.7760
Application of metagenomic next-generation sequencing in the diagnosis of infectious diseases of the central nervous system after empirical treatment
Ying-Ying Chen, Yan Guo, Xin-Hong Xue, Feng Pang
Ying-Ying Chen, Yan Guo, Xin-Hong Xue, Department of Neurology, Liaocheng People's Hospital, Liaocheng 252000, Shandong Province, China
Feng Pang, Central Laboratory, Liaocheng People's Hospital, Liaocheng 252000, Shandong Province, China
Author contributions: Guo Y and Xue XH contributed equally to this work; Guo Y collected data, analysis and drafted the initial manuscript, and reviewed and revised the manuscript; Chen YY and Xue XH performed data analysis, drafted, and revised the manuscript; Xue XH and Pang F reviewed and revised the manuscript; and All authors read and approved the final manuscript.
Institutional review board statement: The protocol has been reviewed by the Human Research Ethics Committee of the Institutional Review Board of Liaocheng people's Hospital Medical College Hospital.
Informed consent statement: The patient has signed an informed consent form.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: The original contributions presented in the study are publicly available
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ying-Ying Chen, PhD, Additional Professor, Department of Neurology, Liaocheng People's Hospital, No. 67 Dongchang West Road, Liaocheng 252000, Shandong Province, China. chen323232azqiqi@163.com
Received: February 11, 2022 Peer-review started: February 11, 2022 First decision: April 13, 2022 Revised: April 27, 2022 Accepted: June 13, 2022 Article in press: June 13, 2022 Published online: August 6, 2022 Processing time: 160 Days and 22.5 Hours
Abstract
BACKGROUND
The diagnostic value of metagenomic next-generation sequencing (mNGS) in central nervous system (CNS) infectious diseases after empirical treatment has not been reported.
AIM
To investigate the diagnostic value of mNGS of cerebrospinal fluid (CSF) in the empirically treated CNS infectious diseases.
METHODS
A total of 262 CSF samples from patients with suspected CNS infections were collected between August 2020 and December 2021. Both mNGS and conventional methods were used for testing. The conventional methods included microbial culture, smear, polymerase chain reaction, etc.
RESULTS
Among 262 suspected cases, 183 cases (69.84%) were diagnosed as CNS infection, including 86 cases of virus infection (47.00%), 70 cases of bacterial infection (38.25%) and 27 cases of fungal infection (14.76%). The sensitivity and specificity of mNGS were 65.6% (95%CI: 58.2%-72.3%) and 89.6% (95%CI: 79.1%-95.3%), respectively. The PPV of mNGS was 94.5% (95%CI: 88.6%-97.6%), and the NPV was 48.8% (95%CI: 39.7%–57.9%). The pathogen detective sensitivity and accuracy of mNGS were higher than those of conventional methods (Sensitivity: 65.6% vs 37.2%; P < 0.001; Accuracy: 72.0% vs 50%, P < 0.001). The results showed that compared with conventional methods, mNGS technology was a more sensitive method for the diagnosis of CNS infection after empirical treatment.
CONCLUSION
mNGS can be a better method applied in the diagnosis of CNS infection after empirical treatment.
Core Tip: The study found that metagenomic next-generation sequencing (mNGS) had a higher sensitivity than the conventional methods in the diagnosis of infectious diseases of the central nervous system after empirical treatment. mNGS has significant clinical value and should be used mainly in early pathogen diagnosis in the future.
