Department of Neurosurgery, The People's Hospital of Pingyang, Wenzhou, Zhejiang 325400, P.R. China.
Department of Research Service, Zhiyuan Inspection Medical Institute Co., Ltd., Hangzhou, Zhejiang 310006, P.R. China.
Mol Med Rep. 2017 Oct;16(4):3938-3946. doi: 10.3892/mmr.2017.7082. Epub 2017 Jul 24.
Intracranial infection is one of the most serious complications following neurosurgery. It is well acknowledged that bacteria and fungi are the main pathogens responsible for postoperative intracranial infection. However, the microbial community structure, including composition, abundance and diversity, in postoperative intracranial infection is not fully understood, which greatly compromises our understanding of the necessity and effectiveness of postoperative antibiotic treatment. The present study collected eight cerebrospinal fluid (CSF) samples from patients with intracranial infection following neurosurgical procedures. High‑throughput amplicon sequencing for 16S rDNA and internal transcribed spacer (ITS) was performed using the Illumina MiSeq platform to investigate the microbial community composition and diversity between treated and untreated patients. Bioinformatics analysis revealed that the microbial composition and diversity in each patient group (that is, with or without antibiotic treatment) was similar; however, the group receiving antibiotic treatment had a comparatively lower species abundance and diversity compared with untreated patients. At the genus level, Acinetobacter and Staphylococcus were widely distributed in CSF samples from patients with postoperative intracranial infection; in particular, Acinetobacter was detected in all CSF samples. In addition, five ITS fungal libraries were constructed, and Candida was detected in three out of four patients not receiving antibiotic treatment, indicating that the fungal infection should be given more attention. In summary, 16S and ITS high‑throughput amplicon sequencing were practical methods to identify pathogens in the different periods of treatment in patients with postoperative intracranial infection. There was a notable difference in microbial composition and diversity between the treated and untreated patients. Alterations in the microbial community structure may provide a signal whether antibiotic treatment worked in postoperative intracranial infection and may assist surgeons to better control the progression of infection.
颅内感染是神经外科术后最严重的并发症之一。众所周知，细菌和真菌是导致术后颅内感染的主要病原体。然而，术后颅内感染的微生物群落结构，包括组成、丰度和多样性，尚未完全了解，这极大地限制了我们对术后抗生素治疗的必要性和有效性的理解。本研究从接受神经外科手术后发生颅内感染的 8 例患者的脑脊液（CSF）样本中采集。使用 Illumina MiSeq 平台对 16S rDNA 和内部转录间隔区（ITS）进行高通量扩增子测序，以研究治疗和未治疗患者之间的微生物群落组成和多样性。生物信息学分析显示，每个患者组（即接受或未接受抗生素治疗）的微生物组成和多样性相似；然而，接受抗生素治疗的组与未治疗的患者相比，物种丰度和多样性较低。在属水平上，不动杆菌属和葡萄球菌属广泛分布于术后颅内感染患者的 CSF 样本中；特别是不动杆菌属在所有 CSF 样本中均有检出。此外，构建了 5 个 ITS 真菌文库，在未接受抗生素治疗的 4 名患者中有 3 名患者中检测到了念珠菌，这表明真菌感染应得到更多关注。综上所述，16S 和 ITS 高通量扩增子测序是鉴定术后颅内感染患者不同治疗阶段病原体的实用方法。治疗和未治疗患者之间的微生物组成和多样性存在显著差异。微生物群落结构的改变可能为抗生素治疗在术后颅内感染中的效果提供信号，并可能有助于外科医生更好地控制感染的进展。
