Han Benfa, Zhang Xiaoli, Li Xiuxi, Chen Mei, Ma Yanlin, Zhang Yunxia, Huo Song
Department of Infectious Diseases, Southern Central Hospital of Yunnan Province, The First People's Hospital of HongHe State, Honghe, 661000, Yunnan, China.
Department of Pharmaceutical, Southern Central Hospital of Yunnan Province, The First People's Hospital of HongHe State, Honghe, 661000, Yunnan, China.
Open Life Sci. 2024 Sep 9;19(1):20220938. doi: 10.1515/biol-2022-0938. eCollection 2024.
Intracranial infection (ICI) is a frequent and serious complication after neurosurgery. Macrogenome next-generation sequencing (mNGS) technology can provide reference for clinical diagnosis and treatment of ICI. This work aimed to explore the application value of mNGS technology in analyzing the clinical characteristics of human immunodeficiency virus (HIV) infection and ICI after neurosurgery. A total of 60 patients with ICI were enrolled as the research objects, all patients underwent routine cerebrospinal fluid analysis and traditional pathogen detection, followed by mNGS genome analysis. Using clinical diagnosis of ICI as the gold standard, the sensitivity, specificity, positive predictive value, and negative predictive value for both detection methods were calculated. Receiver operating characteristic curves were constructed to assess the area under the curve (AUC) for evaluating the clinical value of mNGS in suspected intracranial infectious pathogen diagnosis. Results showed a positivity rate of 71.67% (43 cases) with mNGS compared to 28.33% (17 cases) with traditional pathogen detection methods, demonstrating a significant difference ( < 0.05). The sensitivity of mNGS for detecting ICIs was 83.7%, significantly higher than the 34.88% observed with traditional methods ( < 0.05). The pathogen detection rate of mNGS was higher than traditional methods ( = 0.002), with an AUC of 0.856 (95% CI: 0.638-0.967), significantly greater than the AUC of 0.572 (95% CI: 0.350-0.792) for traditional methods ( < 0.05). mNGS successfully identified microorganisms such as , , , , , and associated with ICIs. These findings underscore the clinical applicability of mNGS technology in analyzing the characteristics of HIV infection and ICI post-neurosurgical procedures. This technology enables more accurate diagnosis and treatment of ICIs, providing valuable insights for developing effective therapeutic strategies.
颅内感染（ICI）是神经外科手术后常见且严重的并发症。宏基因组下一代测序（mNGS）技术可为ICI的临床诊断和治疗提供参考。本研究旨在探讨mNGS技术在分析神经外科手术后人类免疫缺陷病毒（HIV）感染和ICI临床特征方面的应用价值。共纳入60例ICI患者作为研究对象，所有患者均接受常规脑脊液分析和传统病原体检测，随后进行mNGS基因组分析。以ICI的临床诊断为金标准，计算两种检测方法的灵敏度、特异度、阳性预测值和阴性预测值。构建受试者工作特征曲线以评估曲线下面积（AUC），用于评估mNGS在疑似颅内感染病原体诊断中的临床价值。结果显示，mNGS的阳性率为71.67%（43例），而传统病原体检测方法的阳性率为28.33%（17例），差异有统计学意义（<0.05）。mNGS检测ICI的灵敏度为83.7%，显著高于传统方法的34.88%（<0.05）。mNGS的病原体检测率高于传统方法（=0.002），AUC为0.856（95%CI：0.638 - 0.967），显著大于传统方法的AUC 0.572（95%CI：0.350 - 0.792）（<0.05）。mNGS成功鉴定出与ICI相关的微生物如 、 、 、 、 和 。这些发现强调了mNGS技术在分析神经外科手术后HIV感染和ICI特征方面的临床适用性。该技术能够更准确地诊断和治疗ICI，为制定有效的治疗策略提供有价值的见解。
