| 杨艳,祁亚平,田启运.宏基因组二代测序与细菌培养对儿童中枢神经系统感染的诊断价值比较[J].安徽医药,2025,29(4):777-780. |
| 宏基因组二代测序与细菌培养对儿童中枢神经系统感染的诊断价值比较 |
| Comparison of clinical diagnostic values of macrogenomic next-generation sequencing and bacterial culture in children with suspected central nervous system infections |
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| DOI：10.3969/j.issn.1009-6469.2025.04.029 |
| 中文关键词: 中枢神经系统感染 宏基因组二代测序 脑脊液 细菌培养 儿童 |
| 英文关键词: Central nervous system infections Macrogene sequencing Cerebrospinal fluid Bacterial culture Child |
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| 中文摘要: |
| 目的比较宏基因组二代测序( mNGS)与细菌培养对疑似中枢神经系统感染( CNSI)儿童的临床诊断价值。方法收集 2020年 6月至 2023年 1月于漯河市第二人民医院住院的疑似 CNSI病儿 120例脑脊液标本，并行 mNGS检测和细菌培养。计算诊断 CNSI的灵敏度、特异度、阳性预测值、阴性预测值，评估两种方法诊断 CNSI的临床价值，比较两种方法送检至收到反馈结果的时间。结果纳入的 120例疑似 CNSI病儿中，临床诊断出 CNSI病人 78例。 mNGS阳性 70例，细菌培养阳性 30例，两种检验方法结果相一致的 26例，细菌培养结果阴性而 mNGS结果阳性 30例，在 42例非 CNSI病人中， mNGS阳性但细菌培养阴性病人 4例，两种检测方法结果均为阴性 4例。 mNGS检测出的革兰阴性菌、革兰阳性菌、病毒和真菌检出构成比依次降低(64.3%>20.0%>11.4%>4.3%)细菌培养检测出的 30例阳性均为革兰阴性菌。根据 CNSI临床诊断标准， mNGS和细菌培养诊 |
| 英文摘要: |
| Objective To compare the clinical diagnostic values of metagenomic next-generation sequencing (mNGS) and bacterialculture (referred to as traditional culture) for suspected central nervous system infections (CNSI) in children.Methods We collected cerebrospinal fluid samples from 120 suspected CNSI children admitted to the Second People's Hospital of Luohe City from June 2020to January 2023, and performed mNGS testing and bacterial culture. Calculations were made of the sensitivity, specificity, positive pre.dictive value, and negative predictive value for the diagnosis of CNSI. The clinical values of the two methods were evaluated, and thetime from sending for testing to receiving feedback results for the two methods was compared.Results Among the included 120 sus.pected CNSI children, 78 cases were confirmed. There were 70 cases positive for mNGS and 30 positive for bacterial culture, with 26cases having consistent results of the two detection methods, and 30 cases negative for bacterial culture but positive for mNGS. Among42 cases clinically diagnosed as non-CNSI, 4 cases were positive for mNGS but negative for bacterial culture and 4 cases negative forboth detection methods. The proportions of gram-negative bacteria, gram-positive bacteria, viruses and fungi detected by mNGS de.creased successively (64.3%>20.0%>11.4%>4.3%), and 30 positive cases were all gram-negative bacteria detected by bacterial cul.ture. Based on CNSI clinical diagnostic criteria, the sensitivities of mNGS and bacterial culture were 89.7%, 38.5%, specificities83.3%, 100.0%, positive predictive values 90.9%, 100.0%, and negative predictive values 81.4%, 46.7%. The AUC 95%CI of CNSI di. agnosed by mNGS was higher than that by traditional culture [0.88 (0.81, 0.95) vs. 0.65 (0.54, 0.76), P<0.05]. The time of mNGS detec.tion from sending for testing to clinicians receiving detection results was significantly shorter than that of bacterial culture [(38.36±4.85) h vs. (198.51±8.47) h, t=26.35, P<0.001]. The feedback time for positive bacteria detected by mNGS was significantly shorterthan that of traditional culture [(32.47±3.14) h vs. (92.68±10.52) h, t=15.63, P<0.001].Conclusion mNGS has high clinical efficacyand high pathogen detection rate in children suspected of CNSI, which is more conducive to guiding clinical drug use. |
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