Clinical metagenomic next-generation sequencing test for diagnosis of central nervous system infections in ICU: a multicenter retrospective study

作者：Jian Liu, Yongquan Dong, Yuanxiu Huang, Mengxiao Xie, Hongyu Wang, Qianqian Wang, Shengfeng Wang, Nan Wang, Yongpo Jiang, Wenxiao Zhang, Mingqiang Wang, Jian Chen, Lingtong Huang, Hongliu Cai · 发表于：International Journal of Infectious Diseases · 年份：2025 · DOI：10.1016/j.ijid.2025.108094 · 被引用次数：4 · 研究领域：Genomics and Phylogenetic Studies、Bacterial Infections and Vaccines、Infectious Encephalopathies and Encephalitis

BACKGROUND: Central nervous system (CNS) infections impose a substantial global burden of morbidity and mortality, necessitating accurate and timely diagnosis for optimal clinical management. Metagenomic next-generation sequencing (mNGS) has been demonstrated as a valuable tool for pathogen detection in patients with suspected CNS infections. METHODS: From December 2019 to June 2023, we conducted a comprehensive analysis of 520 cerebrospinal fluid samples collected from patients with suspected intracranial infections across six intensive care units. All pathogen-positive results identified through metagenomic next-generation sequencing were subsequently validated by an independent laboratory. RESULTS: Metagenomic NGS detected 105 microbial species in 520 clinical samples, comprising 64 bacterial species (61.0%), 16 DNA viruses (15.2%), 13 fungal species (12.4%), and 7 RNA viruses (6.7%). The 30-day mortality rate among all study participants was 18.5%. Metagenomic NGS identified 172 infection cases, whereas conventional culture methods detected only 31 cases. For CNS infections, mNGS demonstrated diagnostic sensitivity, specificity, and accuracy rates of 59%, 90.5%, and 72.5%, respectively. CONCLUSIONS: Metagenomic NGS testing facilitates accelerated diagnosis of CNS infections and informs evidence-based clinical management decisions.