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

上官丽娟, 王海龙, 尚晶, 王智军, 侯苗苗, 薛岚平

武警医学 ›› 2022, Vol. 33 ›› Issue (6) : 472-475.

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武警医学 ›› 2022, Vol. 33 ›› Issue (6) : 472-475.
论著

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

  • 上官丽娟1,2, 王海龙1,2, 尚晶1,2, 王智军1,2, 侯苗苗1,2, 薛岚平1,2
作者信息 +

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

  • SHANG GUAN Lijuan1,2, WANG Hailong1,2, SHANG Jing1,2, WANG Zhijun1,2, HOU Miaomiao1,2, XUE Lanping1,2
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摘要

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。

Abstract

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.

关键词

宏基因 / 二代测序 / 中枢神经系统感染性疾病 / 准确率

Key words

metagenomic / next-generation sequencing / central nervous system infections / accuracy

引用本文

导出引用
上官丽娟, 王海龙, 尚晶, 王智军, 侯苗苗, 薛岚平. 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[J]. 武警医学. 2022, 33(6): 472-475
SHANG GUAN Lijuan, WANG Hailong, SHANG Jing, WANG Zhijun, HOU Miaomiao, XUE Lanping. Application of metagenomic next-generation sequencing in diagnosis of infectious diseases of central nervous system[J]. Medical Journal of the Chinese People Armed Police Forces. 2022, 33(6): 472-475
中图分类号: R741   

参考文献

[1] Wilson M R, Naccache S N, Samayoa E, et al. Actionable diagnosis of neuroleptospirosis by next-generation sequencing[J]. N Engl J Med, 2014, 370(25): 2408-2417.
[2] Li M H, Li Y J, Hu B, et al. Clinical characteristics and next generation sequencing of three cases of Listeria monocytogenes meningitis with complications[J]. Zhonghua Erke Zazhi, 2019, 57(8): 603-607.
[3] 赵伟丽, 张武超, 赵 焱,等.伪狂犬病毒脑炎临床观察与脑脊液二代测序鉴定[J]. 中华医学杂志,2018, 98(15):1152-1157.
[4] Guan H, Shen A, Lv X, et al. Detection of virus in CSF from the cases with meningoencephalitis by next-generation sequencing[J]. J Neurovirol, 2016, 22(2): 240-245.
[5] 贾建平.神经病学[M]. 3版.北京:人民卫生出版社,2018:123.
[6] 宏基因组分析和诊断技术在急危重症感染应用专家共识组. 宏基因组分析和诊断技术在急危重症感染应用的专家共识[J]. 中华急诊医学杂志,2019, 28(2):151-155.
[7] 中华医学会神经病学分会感染性疾病与脑脊液细胞学学组. 中枢神经系统感染性疾病的脑脊液宏基因组学第二代测序应用专家共识[J]. 中华神经科杂志, 2021, 54(12):1234-1240.
[8] Wang S, Chen Y, Wang D, et al. The feasibility of metagenomic next-generation sequencing to identify pathogens causing tuberculous meningitis in cerebrospinal fluid[J]. Front Microbiol, 2019, 10: 1993.
[9] Wilson M R, Sample H A, Zorn K C, et al. Clinical metagenomic sequencing for diagnosis of meningitis and encephalitis[J]. N Engl J Med, 2019, 380(24): 2327-2340.
[10] 刘 磊, 张景晓, 狄晓萌,等. 送检脑脊液病原宏基因组第二代测序技术客观标准再探讨[J]. 中国现代神经疾病杂志, 2021, 21(5):350-357.
[11] Miao Q, Ma Y, Wang Q, et al. Microbiological diagnostic performance of metagenomic next-generation sequencing when applied to clinical practice[J]. Clin Infect Dis,2018, 67(suppl_2): S231-S240.
[12] Zhang Y, Cui P, Zhang H C, et al. Clinical application and evaluation of metagenomic next-generation sequencing in suspected adult central nervous system infection[J]. J Transl Med, 2020, 18(1): 199.
[13] Nigrovic L E, Malley R, Macias C G, et al. Effect of antibiotic pretreatment on cerebrospinal fluid profiles of children with bacterial meningitis[J]. Pediatrics,2008, 122(4): 726-730.
[14] Fan S Y, Wang X, Hu Y, et al. Metagenomic next-generation sequencing of cerebrospinal fluid for the diagnosis of central nervous system infections: a multicentre prospective study[EB/OL]. (2019-06-10) .[2020-09-17].https://www.biorxiv.org/content/10.1101/658047v1.
[15] Xing X W, Zhang J T, Ma Y B, et al. Metagenomic next-generation sequencing for diagnosis of infectious encephalitis and meningitis: a large, prospective case series of 213 patients[J]. Front Cell Infect Microbiol,2020, 10: 88.
[16] 赵伟丽, 林福虹, 乔小东,等.应用二代测序诊断中枢神经系统感染性疾病的回顾性分析[J]. 中华神经科杂志,2020, 53(12):1016-1020.
[17] Simner P J, Miller S, Carroll K C. Understanding the promises and hurdles of metagenomic next-generation sequencing as a diagnostic tool for infectious diseases[J]. Clin Infect Dis, 2018,66(5): 778-788.
[18] 冯国栋, 贺 旻, 汪 昕. 二代测序技术在诊断神经系统感染性疾病中的应用[J]. 诊断学理论与实践,2018, 17(4):391-395.

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