宏基因组第二代测序技术在神经外科颅内感染病原学诊断中的应用初探

目的 探讨基于宏基因组的第二代测序技术(mNGS)在神经外科手术后并发颅内感染诊断中的应用价值.方法 前瞻性纳入2019年1-10月共15例神经外科手术后拟诊颅内感染患者,2周后由3位神经外科专家共同判断是否确诊颅内感染.腰椎穿刺留取脑脊液标本,分别行常规、生化、细菌涂片和细菌培养以及mNGS测序.结果 共8例患者临床确诊术后颅内感染,其中4例脑脊液mNGS测序(序列数分别为212、329、1601和5371)和细菌培养(鲍曼不动杆菌2例、皮特不动杆菌1例、产气肠杆菌1例)均呈阳性;4例经随访临床确诊术后颅内感染,但脑脊液mNGS测序和细菌培养均呈阴性.7例临床诊断为无菌性脑膜炎,其中3例脑脊...

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Published in中国现代神经疾病杂志 Vol. 20; no. 8; pp. 682 - 687
Main Authors 徐跃峤, 齐猛, 尚峰, 杨昆, 洪韬, 曲鑫, 王宁
Format Journal Article
LanguageChinese
Published 100053北京,首都医科大学宣武医院神经外科%100053北京,首都医科大学宣武医院循证医学中心 25.08.2020
Subjects
基因检测
宏基因组
手术后并发症
神经外科手术
中枢神经系统感染
Online AccessGet full text
ISSN1672-6731
DOI10.3969/j.issn.1672-6731.2020.08.004

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Abstract 目的 探讨基于宏基因组的第二代测序技术(mNGS)在神经外科手术后并发颅内感染诊断中的应用价值.方法 前瞻性纳入2019年1-10月共15例神经外科手术后拟诊颅内感染患者,2周后由3位神经外科专家共同判断是否确诊颅内感染.腰椎穿刺留取脑脊液标本,分别行常规、生化、细菌涂片和细菌培养以及mNGS测序.结果 共8例患者临床确诊术后颅内感染,其中4例脑脊液mNGS测序(序列数分别为212、329、1601和5371)和细菌培养(鲍曼不动杆菌2例、皮特不动杆菌1例、产气肠杆菌1例)均呈阳性;4例经随访临床确诊术后颅内感染,但脑脊液mNGS测序和细菌培养均呈阴性.7例临床诊断为无菌性脑膜炎,其中3例脑脊液mNGS测序序列数＜100;1例脑室外引流管管头细菌培养为表皮葡萄球菌,但脑脊液mGNS测序呈阴性,随访后确认为污染所致.脑脊液mNGS测序诊断术后颅内感染的灵敏度为4/8、特异度为7/7,准确率为11/15.结论 初步证实mNGS测序诊断神经外科手术后并发颅内感染有一定价值,可以作为传统检测方法的有效补充,但mNGS测序结果须结合临床实际情况合理判读.
AbstractList 目的 探讨基于宏基因组的第二代测序技术(mNGS)在神经外科手术后并发颅内感染诊断中的应用价值.方法 前瞻性纳入2019年1-10月共15例神经外科手术后拟诊颅内感染患者,2周后由3位神经外科专家共同判断是否确诊颅内感染.腰椎穿刺留取脑脊液标本,分别行常规、生化、细菌涂片和细菌培养以及mNGS测序.结果 共8例患者临床确诊术后颅内感染,其中4例脑脊液mNGS测序(序列数分别为212、329、1601和5371)和细菌培养(鲍曼不动杆菌2例、皮特不动杆菌1例、产气肠杆菌1例)均呈阳性;4例经随访临床确诊术后颅内感染,但脑脊液mNGS测序和细菌培养均呈阴性.7例临床诊断为无菌性脑膜炎,其中3例脑脊液mNGS测序序列数＜100;1例脑室外引流管管头细菌培养为表皮葡萄球菌,但脑脊液mGNS测序呈阴性,随访后确认为污染所致.脑脊液mNGS测序诊断术后颅内感染的灵敏度为4/8、特异度为7/7,准确率为11/15.结论 初步证实mNGS测序诊断神经外科手术后并发颅内感染有一定价值,可以作为传统检测方法的有效补充,但mNGS测序结果须结合临床实际情况合理判读.
Author 杨昆
曲鑫
齐猛
王宁
徐跃峤
尚峰
洪韬
AuthorAffiliation 100053北京,首都医科大学宣武医院神经外科%100053北京,首都医科大学宣武医院循证医学中心
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Author_FL HONG Tao
XU Yue-qiao
WANG Ning
QU Xin
QI Meng
YANG Kun
SHANG Feng
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Keywords 基因检测
宏基因组
手术后并发症
神经外科手术
中枢神经系统感染
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