Department of Neurology, Chinese PLA General Hospital, Beijing 100853, PR China.
Medical School of Chinese PLA, Beijing 100853, PR China.
J Med Microbiol. 2019 Aug;68(8):1204-1210. doi: 10.1099/jmm.0.000994. Epub 2019 Jun 11.
In recent years, metagenomic next-generation sequencing (mNGS) has become widely used in medical microbiology to detect pathogen infection.
We aimed to assess the diagnostic performance of mNGS of cerebrospinal fluid (CSF) for prediction of cryptococcal meningitis (CM).
A comparative evaluation of mNGS (performed on CSF samples) and conventional methods, including India ink staining, culture for fungi and cryptococcal-antigen (CrAg) detection by enzyme immunoassay, was performed on 12 consecutive non-HIV-infected patients with chronic or subacute CM.
India ink staining and culture of the CSF were positive for Cryptococcus in 83.33 % (10/12) of the samples; 100 % (11/11) were positive via CrAg EIA. The mNGS results of the CSF identified DNA sequences corresponding to Cryptococcus in 75 % of samples (9/12). However, the DNA of both C. neoformans s.l. and C. gattii s.l. was detected concurrently in 33.33 % (4/12).
mNGS is helpful for identifying Cryptococcus species. The application of mNGS, together with India ink staining, culture methods, and CrAg, may significantly improve the diagnostic precision in CM, thereby informing choice of appropriate antifungal treatment courses.
近年来，宏基因组下一代测序（mNGS）已广泛应用于医学微生物学，以检测病原体感染。
我们旨在评估 mNGS 对脑脊液（CSF）中隐球菌性脑膜炎（CM）预测的诊断性能。
对 12 例连续的非 HIV 感染的慢性或亚急性 CM 患者的脑脊液（CSF）样本进行了 mNGS（CSF 样本）与常规方法（包括印度墨水染色、真菌培养和酶免疫分析检测隐球菌抗原（CrAg））的比较评估。
印度墨水染色和 CSF 培养对隐球菌呈阳性的比例为 83.33%（10/12）；CrAg EIA 检测的阳性率为 100%（11/11）。CSF 的 mNGS 结果在 75%的样本（9/12）中鉴定出了与隐球菌相对应的 DNA 序列。然而，在 33.33%的样本（4/12）中同时检测到了新型隐球菌复合群和格特隐球菌复合群的 DNA。
mNGS 有助于鉴定隐球菌属。mNGS 与印度墨水染色、培养方法和 CrAg 联合应用，可能显著提高 CM 的诊断精度，从而为选择适当的抗真菌治疗方案提供信息。
