Pathogen Diagnostic Value of Nanopore Sequencing in Postoperative Central Nervous System Infections

To evaluate the diagnostic performance of nanopore sequencing in postoperative central nervous system infections (PCNSIs).

A total of 34 patients with suspected PCNSIs after craniocerebral surgery were included from the Aviation General Hospital between June 2022 and October 2023. Cerebrospinal fluid samples were collected immediately. Clinical information was gathered for all patients, and tests including blood routine examination, biochemical analysis, microbial culture, metagenomic next-generation sequencing (mNGS), and nanopore sequencing were performed. Relevant data were compiled.

Among 34 patients suspected of PCNSIs, nanopore sequencing identified specific pathogenic sequences in 27 (79.41% positivity), surpassing both mNGS (73.53%) and microbial culture (55.88%). Compared to microbial culture and mNGS, nanopore sequencing demonstrated superior sensitivity (79.41%) and diagnostic performance, thereby minimizing the missed diagnosis rate of microbial culture (36.67% vs. 11.76%). Nanopore sequencing combined with microbial culture shows significant consistency with the final clinical diagnosis (K = 0.717, P < 0.05). In contrast, the consistency of using microbial culture alone with the final clinical diagnosis is lower (K = 0.289, P < 0.05), suggesting that microbial culture may have limitations in certain situations.

Compared to microbial culture and mNGS, nanopore sequencing has a higher pathogen detection rate and a lower missed diagnosis rate. In clinical practice, using nanopore sequencing as a supplement to microbial culture can aid in the diagnosis of PCNSIs.