Chen Fang, Zhao Yujing, Shen Chuan, Han Longzhi, Chen Xiaosong, Zhang Jianjun, Xia Qiang, Qian Yongbing
Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Ann Transl Med. 2021 Jul;9(13):1071. doi: 10.21037/atm-21-92.
Fungal encephalitis is uncommon and sometimes fatal in liver transplant (LT) recipients. Early diagnosis of central nervous system (CNS) fungal infections, especially aspergillosis, is difficult based on routine tests of cerebrospinal fluid (CSF) alone. Next-generation sequencing (NGS) as a new tool may help in this respect.
Shotgun metagenomics was used to detect pathogens in CSF of patients, who were clinically suspected of CNS infection. Sequencing was performed at BGIseq-50 platform (BGI, Shenzhen).
NGS technique identified in CSF of 5 patients, who were suspected of CNS infection, although clinical symptoms of these patients varied dramatically. The resulting sequence reads corresponding to species ranged from 2 to 25, with genomic coverage ranging from 0.0003% to 0.0036%. Rapid identification of enabled early appropriate antifungal therapy, although 4 patients eventually died of severe infection.
This is the first study to highlight the utility of NGS in early diagnosis of CNS aspergillosis in LT recipients. This new tool may be helpful in improving the diagnosis of CNS aspergillosis.
真菌性脑炎在肝移植（LT）受者中并不常见，有时甚至会致命。仅基于脑脊液（CSF）的常规检测，很难对中枢神经系统（CNS）真菌感染，尤其是曲霉病进行早期诊断。作为一种新工具，下一代测序（NGS）在这方面可能会有所帮助。
采用鸟枪法宏基因组学检测临床怀疑有中枢神经系统感染患者脑脊液中的病原体。测序在BGIseq - 50平台（深圳华大基因）上进行。
NGS技术在5例临床怀疑有中枢神经系统感染的患者脑脊液中鉴定出 ，尽管这些患者的临床症状差异很大。对应于 物种的测序读数从2到25不等，基因组覆盖率从0.0003%到0.0036%。 的快速鉴定使得能够尽早进行适当的抗真菌治疗，尽管4例患者最终死于严重感染。
这是第一项强调NGS在肝移植受者中枢神经系统曲霉病早期诊断中的作用的研究。这种新工具可能有助于改善中枢神经系统曲霉病的诊断。
