Research on the Application Value of tNGS in the Diagnosis of Bacterial Central Nervous System Infections in Children

WENG Ting; WANG Chengyi

doi:10.13919/j.issn.2095-6274.ZHJY202505001

Abstract：Objective To explore the application value of targeted next-generation sequencing(tNGS)in the diagnosis of bacterial central nervous system(CNS)infections in children.Methods A total of 61 children with suspected bacterial CNS infections admitted to our hospital from August 2023 to November 2024 were select-ed.Cerebrospinal fluid(CSF)samples were collected and subjected to both traditional microbial culture and tNGS testing.The pathogen distribution results of traditional microbial culture and tNGS in diagnosing CNS infections were compared.Using pathogen culture or PCR-based pathogen DNA detection in CSF as the"gold standard,"the diagnostic efficacy of traditional microbial culture and tNGS for CNS infections was analyzed.Additionally,the turnaround times of traditional microbial culture and tNGS were compared.Results Among the 61 suspected CNS infected children,41 cases(67.21％)were confirmed to have CNS bacterial infections by pathogen culture or PCR pathogen DNA testing,and 20 cases(32.79％)were confirmed to have non CNS bacterial infections by pathogen culture or PCR pathogen DNA testing.Among the 41 confirmed CNS bacterial infections,tNGS detected pathogens in 34 cases(82.93％)of the children,including 26 cases(76.47％)of gram-negative bacteria and 8 cases(23.53％)of gram-positive bacteria;16 cases of traditional microbial culture were positive,all of which were Gram negative bacteria;The sensitivity of tNGS in diagnosing CNS bacterial infections was 82.93％(34/41),the negative predictive value was 70.83％(17/24),and the accuracy was 83.61％(51/61),all of which were higher than tra-ditional microbial culture and had statistical differences(P＜0.05);There was no statistically significant difference(P＞0.05)in the positive predictive value and specificity of tNGS diagnosis of CNS infection compared to traditional microbial culture;The tNGS examination time was(20.25±2.34)hours,significantly shorter than that of traditional microbial culture(92.70±10.47)hours,with statis-tical differences(P＜0.05).Conclusion Compared with traditional microbial culture,tNGS can accurately diag-nose bacterial CNS infections,identify pathogen types,and provide a reliable reference for clinical treatment.