Augmented pathogen detection in brain abscess using metagenomic next-generation sequencing: a retrospective cohort...

Area of Science:

• Neurology
• Infectious Diseases
• Microbiology

Background:

• Brain abscess is a serious infection requiring precise pathogen identification for effective treatment.
• Conventional culture methods have limitations in detecting the full spectrum of causative agents, particularly anaerobes.

Purpose of the Study:

• To compare the diagnostic performance of conventional culture and metagenomic next-generation sequencing (mNGS) for pathogen detection in brain abscess.
• To evaluate the ability of mNGS to identify a broader range of pathogens, including anaerobes, compared to culture.

Main Methods:

• A 10-year retrospective study of 612 patients with brain abscess, analyzing 174 cases with confirmed etiology.
• Comparison of pathogen detection rates in pus and cerebrospinal fluid (CSF) samples using culture and mNGS.

Main Results:

• mNGS showed significantly higher overall pathogen-positive rates in pus (85.0% vs 50.0%) and CSF (84.2% vs 7.9%) compared to culture.
• mNGS detected anaerobes more effectively in pus (50.0% vs 10%) and CSF (18.4% vs 0%) samples.
• mNGS identified a more diverse pathogen spectrum, including rare and fastidious organisms, in culture-negative cases.

Conclusions:

• mNGS offers superior pathogen detection capabilities for brain abscess compared to conventional culture.
• mNGS is a valuable supplementary diagnostic tool for comprehensive and accurate identification of brain abscess pathogens, especially anaerobes.
• Improved pathogen identification via mNGS can lead to more targeted and effective patient treatment strategies.