Evaluation of metagenomic and pathogen-targeted next-generation sequencing for diagnosis of meningitis and encephalitis in adults: A multicenter prospective observational cohort study in China - 30/04/24
, Yan Zhang a, f, ⁎ Summary |
Background |
Next-generation sequencing (NGS) might aid in the identification of causal pathogens. However, the optimal approaches applied to cerebrospinal fluid (CSF) for detection are unclear, and studies evaluating the application of different NGS workflows for the 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 tests 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.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | Detection efficiencies of ptNGS for pathogen detection in CSF were higher than mNGS. |
• | False positive rate of ptNGS for infectious M/E was lower than mNGS. |
• | ptNGS had superior performance over mNGS in CSF for the common pathogen. |
• | ptNGS had more potential than mNGS in detecting target viruses in CSF |
Keywords : Encephalitis, Metagenomic next-generation sequencing, Pathogen-targeted next-generation sequencing, Cerebrospinal fluid
Plan
Vol 88 - N° 5
Article 106143- mai 2024 Retour au numéro
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