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在中枢神经系统感染中检测病原体的元基因组测序的多中心评估

Jiali Wang¹, Yu Ma¹, Xiankun Shi²

¹National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P. R. China; National Center for Clinical Laboratories, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P. R. China.

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

|January 30, 2026

概括

下一代元基因组测序 (mNGS) 显示出对诊断中枢神经系统 (CNS) 感染的前景. 改善污染控制和RNA病毒检测方法对于提高mNGS在临床诊断中的准确性至关重要.

科学领域:

临床诊断临床诊断临床诊断
传染病传染病传染病传染病
基因组学就是基因组学.

背景情况:

下一代元基因组测序 (mNGS) 是一种强大的工具,用于识别脑脊液 (CSF) 中的病原体.
在CSF样本中的低生物量带来了挑战,包括污染和宿主背景干扰,可能会影响诊断准确性.
需要在实验室中进行标准化,以优化对中枢神经系统 (CNS) 感染的mNGS性能.

研究的目的:

在多个临床和研究实验室中评估CSFmNGS的性能.
确定影响mNGS检测中枢神经系统病原体准确性的关键方法因素.
评估污染和宿主背景对mNGS结果的影响.

主要方法:

使用了15个CSF样本的参考面板,包括复制品,度梯度,抗干扰样本和模拟病例.
共有127个实验室参与其中,使用他们独立开发的mNGS工作流程.
评估了准确性,可重复性,灵敏性和抗干扰能力,并分析了错误来源和影响因素.

主要成果:

总体而言,mNGS的表现良好 (平均F1得分为0.98),但观察到显著的差异.
实验污染是错误阳性 (83.43%) 的主要来源,而RNA病毒占大多数错误阴性 (57.14%).
微生物丰富 (DNase,Kraken2) 改善了DNA病原体的检测,但没有RNA病毒;样品颗粒化通常会损害检测.

结论:

这项研究强调了在CSF mNGS工作流程中加强污染控制的必要性.
优化RNA病毒的检测方法对于提高诊断灵敏度至关重要.
完善湿实验室程序和生物信息管道是必要的,以加强mNGS对中枢神经系统感染的临床实用性.

关键词:

中枢神经系统感染中枢神经系统感染大脑脊髓液中的脑脊液.下一代元基因组测序的测序.

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