Application of cerebrospinal fluid metagenomic next-generation sequencing in emergency patients with suspected central nervous system infection
Lyu Junhua
Sun Baoni
Bai Zhenghai
Wang Xiaobo
Pei Honghong
Pan Longfei
Abstract：Objective To evaluate the value of metagenomic next-generation sequencing(mNGS)in emergency patients with suspected central nervous system(CNS)infection.Methods The results of routine test and mNGS test were retrospectively analyzed for cerebrospinal fluid(CSF)samples of 109 patients with confirmed or suspected CNS infection admitted into Department of Emergency Medicine,the Second Affiliated Hospital of Xi′an Jiaotong University from September 2019 to December 2023.109 patients were divided into the intracranial infection group(n =59)and the non-intracranial infection group(n =50).Basic information and clinical examination results in two groups were compared,the meaningful indicators were incorporated into regression analysis for establishing predictive model.The receiver operating characteristic(ROC)curves were drawn,and the area under the cure(AUC)was calculated to evaluate the performance of predictive model.Results The positive mNGS(95%CI 5.247-64.230),headache(95%CI 1.471-14.990),white blood cell count in cerebrospinal fluid 16(95%CI 1.211-11.962)×106/L and intracranial pressure>170(95%CI 1.034-9.801)cmH2 O were independent predictors of acute CNS infection.The AUC of the prediction model was 0.911 combined with clinical ymptoms and routine microbiological testing,which was larger than that of mNGS(0.801)and the traditional test(0.832).Conclusions The cerebrospinal fluid mNGS combined with clinical symptoms and routine microbioloical testing is an important complement to clinical testing,which can greatly improve diagnostic efficacy while identifying pathogens.
Keywords：Central nervous system(CNS)InfectionsuspectedMetagenomic next-generation sequencing(mNGS)
Publication Date：2024-04-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 356-360 )