宏基因二代测序在中枢神经系统感染性疾病诊断中的应用

 目的 探讨宏基因二代测序(metagenomic next-generation sequencing,mNGS)在中枢神经系统感染性疾病诊断中的应用价值。方法 回顾分析2019-01至2021-12山西白求恩医院神经内科收治的85例中枢神经系统感染性疾病患者,系统收集各项资料,探究mNGS在该类疾病诊断应用中的优势。结果 85例中,mNGS检出病原体21种,检出阳性57例,其中与最终诊断符合48例,不符合9例,准确率为56.5%(48/85);传统方法检出阳性23例,其中与最终诊断符合22例,不符合1例,准确率25.9%(22/85),两种方法准确率差异有统计学意义(P＜0.05)。结论 较传统方法而言,宏基因二代测序对中枢神经系统感染性疾病的准确率高,可以作为传统方法的互补方法,但因mNGS检出结果与最终诊断不符情况较多,检测结果的判读应结合临床慎重考虑。

Application of metagenomic next-generation sequencing in diagnosis of infectious diseases of central nervous system

Objective To investigate the application value of metagenomic next-generation sequencing (mNGS) in the diagnosis of infectious diseases of central nervous system (CNS infectious diseases).Methods The clinical data of 85 patients with CNS infectious diseases admitted to the Neurology Department of Shanxi Bethune Hospital from January 2019 to December 2021 were retrospectively analyzed to explore the advantages of mNGS.Results Twenty-one kinds of pathogens were detected by mNGS, 57 cases were positive, 48 cases were in accordance with clinical diagnosis, 9 cases were not, and the accuracy was 56.5%(48/85); 23 cases were positive by traditional methods, 22 cases were in accordance with clinical diagnosis, 1 case was not, and the accuracy was 25.9%(22/85). The difference between the two methods was significant (P<0.05).Conclusions The detection accuracy of mNGS is higher than that of the traditional method, and mNGS can be used as a complementary method to the traditional detection one, but because of the results of mNGS are inconsistent with the clinical diagnosis in many cases, the interpretation of detection results should be carefully considered in combination with clinical practice.