病菌
医学
基因组
前瞻性队列研究
脑膜炎
脑炎
内科学
队列研究
日本脑炎
队列
观察研究
重症监护医学
病毒学
免疫学
生物
儿科
病毒
基因
生物化学
作者
Weibi Chen,Gang Liu,Lili Cui,Fei Tian,Jiatang Zhang,Jinping Zhao,Ying Lv,Jie Du,Xiao Huan,Y H Wu,Yan Zhang
标识
DOI:10.1016/j.jinf.2024.106143
摘要
Abstract
Background
Next-generation sequencing (NGS) might aid in identification of causal pathogens. However, the optimal approaches applied to cerebrospinal fluid (CSF) for detection are unclear, and studies evaluating application of different NGS workflows for diagnosis of intracranial infections are limited. Methods
In this multicenter, prospective observational cohort study, we described the diagnostic efficacy of pathogen-targeted NGS (ptNGS) and metagenomic NGS (mNGS) compared to that of composite microbiologic assays, for infectious meningitis/encephalitis (M/E). Results
In total, 152 patients diagnosed with clinically suspected M/E at four tertiary hospitals were enrolled; ptNGS and mNGS were used in parallel for pathogen detection in CSF. Among the 89 patients who were diagnosed with definite infectious M/E, 57 and 39 patients had causal microbial detection via ptNGS and mNGS, respectively. The overall accuracy of ptNGS was 65.1%, with a positive percent agreement (PPA) of 64% and a negative percent agreement (NPA) of 66.7%; and the overall accuracy of mNGS was 47.4%, with a PPA of 43.8% and an NPA of 52.4% after discrepancy analysis. There was a significant difference in the detection efficiency between these two methods both for PPA (sensitivity) and overall accuracy for pathogen detection (P<0.05). Conclusions
NGS testings have provided new information in addition to conventional microbiologic tests. ptNGS seems to have superior performance over mNGS for common causative pathogen detection in CSF for infectious M/E.
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