Research progress on metagenomic next-generation sequencing in diagnosis of severe central nervous system infection

doi:10.3969/j.issn.1672-6731.2023.06.002

Abstract

Abstract:

The mortality rate of severe central nervous system infection is high. Early identifying pathogens and giving targeted antibiotics are critical to reduce the mortality rate. Traditional pathogen detection technologies are difficult to meet clinical requirements due to technical limitations. Recently, metagenomic next-generation sequencing (mNGS) has received widespread attention in the infectious field due to its efficiency, high throughput and wide coverage of microorganisms. This article reviews the development of mNGS and its application in severe central nervous system infection, so as to provide a more powerful guarantee for accurate diagnosis and treatment of severe central nervous system infection.

Key words: Metagenome, Genetic testing, Central nervous system infections, Review

摘要：

重症中枢神经系统感染病死率较高，早期识别病原体并采取针对性措施是降低病死率的关键。传统病原学检测技术因自身技术缺陷难以满足临床需要，宏基因组第二代测序技术（mNGS）因快速、高通量、覆盖病原微生物范围广的特点，在重症中枢神经系统感染的应用中得到广泛关注。本文综述mNGS测序发展历程及其在重症中枢神经系统感染中的应用进展，为疾病的精准诊断与治疗提供理论依据。

关键词: 宏基因组, 基因检测, 中枢神经系统感染, 综述

Qian DU, Su-jun DENG, Shan ZOU, Jun JIN, Qing-shan ZHOU. Research progress on metagenomic next-generation sequencing in diagnosis of severe central nervous system infection[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2023, 23(6): 479-484.

杜倩, 邓素君, 邹姗, 金珺, 周青山. 宏基因组第二代测序技术在重症中枢神经系统感染中的应用[J]. 中国现代神经疾病杂志, 2023, 23(6): 479-484.

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URL: http://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2023.06.002

http://journal11.magtechjournal.com/cjcnn/EN/Y2023/V23/I6/479

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检测技术	检测原理	优点	缺点	检出时间
病原微生物培养	病原体在特定培养基中繁殖	成本低，操作简便	特定病原体只能在相应培养基生长，操作繁琐，检测时间长，敏感性易受抗生素治疗影响，部分病原体对培养环境要求较高	周级别
病原体抗原抗体测定	抗体或抗原与样本中病原体抗原或抗体特定结合	单次处理样品多，可发现急性感染或既往感染，性价比较高，操作简便	敏感性和特异性低，相近抗原存在交叉反应	小时级别
PCR	靶核酸扩增	定量准确，快速高效，一次可检测多种病原体	易受扩增偏差影响，成本高于病原微生物培养，无法区分活细胞和死细胞，无法区分感染和定植	秒-分钟级别
靶向测序	对基因组中特定基因序列进行测序以识别病原体	高通量，敏感性高	只适用于特定基因片段测序，难以用于新病原体检测，受扩增偏差影响，无法区分活细胞和死细胞，无法区分感染和定植	天级别
mNGS	对样本中所有DNA和（或）RNA进行测序	高通量，快速高效、覆盖病原微生物范围广、直接检测生物样本无需培养、可预测细菌或病毒耐药性	检测成本高，操作步骤较传统病原学检测复杂，操作过程中样本污染风险较高，无法区分活细胞和死细胞，无法区分感染和定植	天级别

检测技术	检测原理	优点	缺点	检出时间
病原微生物培养	病原体在特定培养基中繁殖	成本低，操作简便	特定病原体只能在相应培养基生长，操作繁琐，检测时间长，敏感性易受抗生素治疗影响，部分病原体对培养环境要求较高	周级别
病原体抗原抗体测定	抗体或抗原与样本中病原体抗原或抗体特定结合	单次处理样品多，可发现急性感染或既往感染，性价比较高，操作简便	敏感性和特异性低，相近抗原存在交叉反应	小时级别
PCR	靶核酸扩增	定量准确，快速高效，一次可检测多种病原体	易受扩增偏差影响，成本高于病原微生物培养，无法区分活细胞和死细胞，无法区分感染和定植	秒-分钟级别
靶向测序	对基因组中特定基因序列进行测序以识别病原体	高通量，敏感性高	只适用于特定基因片段测序，难以用于新病原体检测，受扩增偏差影响，无法区分活细胞和死细胞，无法区分感染和定植	天级别
mNGS	对样本中所有DNA和（或）RNA进行测序	高通量，快速高效、覆盖病原微生物范围广、直接检测生物样本无需培养、可预测细菌或病毒耐药性	检测成本高，操作步骤较传统病原学检测复杂，操作过程中样本污染风险较高，无法区分活细胞和死细胞，无法区分感染和定植	天级别

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