机构：[1]Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No. 56 Nan Lishi Road, Beijing 100045, China.职能科室临床流行病与循证医学中心首都医科大学附属北京儿童医院[2]Tianjin Medical Laboratory, BGI-Tianjin, Tianjin, China.[3]State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Science, Beijing 100071, China.
BackgroundThere is currently no research on the diagnostic value of metagenomic next-generation sequencing (mNGS) for a single pathogens in CSF. The aim of this study was to analyse the value of mNGS for identifying Streptococcus pneumoniae (S. pneumoniae) in paediatric bacterial meningitis.MethodsBacterial meningitis (BM) cases from October 23, 2014, to December 31, 2016, and December 1, 2017, to July 31, 2018 at Beijing Children's Hospital were reviewed. Clinical features and pathogens were analysed.ResultsWe diagnosed 135 patients with BM in this study. A total of 43S. pneumoniae were identified by combination methods. 26/135 (19.3%) patients had positive results in S. pneumoniae by blood and/or cerebrospinal fluid (CSF) culture. Alere BinaxNow (R) Streptococcus pneumoniae Antigen test was positive in 35/135(25.9%) cases. 32/135 (23.7%) S. pneumoniae were identified by mNGS. Six CSF samples were identified as S. pneumoniae only by mNGS technology. Taking culture as the gold standard, the sensitivity and specificity of mNGS for diagnosing S. pneumoniae meningitis were 73.1 and 88.1%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) of diagnosing S. pneumoniae meningitis by mNGS were 59.4 and 93.2%, respectively. When comparison between mNGS and combined tests (culture and Alere BinaxNow (R) Streptococcus pneumoniae Antigen test), the sensitivity and specificity of mNGS for S. pneumoniae identification were 70.3 and 93.9%, the PPV and NPV in the identification of S. pneumoniae by mNGS were 81.4 and 89.3%, respectively. The difference in number of unique reads of S. pneumoniaein from CSF sample (<14days onset) and CSF sample (>14days from onset) was statistically significant (170.5 VS. 13, P=0.019). The difference in the collected time of CSF for culture and mNGS was statistically significant (4days VS. 14days, P<0.001).ConclusionsmNGS has high sensitivity and specificity for S. pneumoniae identification. The pathogen load (number of unique reads) of S. pneumonia is related to the CSF collection time. mNGS was less affected than culture by the use of antibiotics before CSF collection.
基金：
Special Fund of The Pediatric Medical Coordinated Development Center of Beijing Municipal Administration [XTZD20180501]; Beijing Hospital Authority "Dengfeng" Talent Training Plan [DFL 20181201]; National Science and Technology Major Project of China [2018ZX10305409]
第一作者机构：[1]Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No. 56 Nan Lishi Road, Beijing 100045, China.
共同第一作者：
通讯作者：
通讯机构：[1]Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No. 56 Nan Lishi Road, Beijing 100045, China.
推荐引用方式(GB/T 7714)：
Zhang Xi-xi,Guo Ling-yun,Liu Lin-lin,et al.The diagnostic value of metagenomic next-generation sequencing for identifying Streptococcus pneumoniae in paediatric bacterial meningitis[J].BMC INFECTIOUS DISEASES.2019,19(1):-.doi:10.1186/s12879-019-4132-y.
APA：
Zhang, Xi-xi,Guo, Ling-yun,Liu, Lin-lin,Shen, Ao,Feng, Wen-ya...&Liu, Gang.(2019).The diagnostic value of metagenomic next-generation sequencing for identifying Streptococcus pneumoniae in paediatric bacterial meningitis.BMC INFECTIOUS DISEASES,19,(1)
MLA：
Zhang, Xi-xi,et al."The diagnostic value of metagenomic next-generation sequencing for identifying Streptococcus pneumoniae in paediatric bacterial meningitis".BMC INFECTIOUS DISEASES 19..1(2019):-
