The Performance of Metagenomic Next-Generation Sequencing In Suspected Central Nervous System Infection

Background: To explore the performance of metagenomic next-generation sequencing (mNGS) technology in patients of suspected central nervous system infection.Methods: From January 2018 to March 2021, 75 cases were enrolled in this retrospective analysis at Hunan Provincial People’s Hospital. The clinical data of patients with suspected central nervous system infection who underwent cerebrospinal fluid mNGS were analyzed. The performances of mNGS were compared with the conventional methods.Result: The sensitivity of mNGS, culture and smear in the diagnosis of 75 patients were 55%, 4.4%, 6.7%; theirs’specificity were 54.3%, 100%, 100%; theirs’ positive predictive value (PPV ) were 57.9%, 100%, 100%; theirs’negative predictive value (NPV) were 51.4%, 41.4%, 41.7%, respectively. There was 41(54.6%) cases whose mNGS results were consistent with the final diagnosis. 22(29.3%) mNGS results were considered as both mNGS positive/Case consistent; 19( 25.3%) mNGS results were considered as both mNGS negative/Case consistent; 18(24%) mNGS results were considered as both mNGS positive/Case inconsistent; 16(21.3%) mNGS results were considered as both mNGS negative/Case inconsistent. mNGS identified 35 irrelavant pathogens in this study.Conclusion: mNGS showed a high sensitivity compared to conventional methods. There are still several challenges in clinical application. It is necessary to establish unified and effective standards for interpreting mNGS results.