Metagenomic Next-Generation Sequencing for Pathogen Detection and Transcriptomic Analysis in Pediatric Central Nervous System Infections
| Autor: | Nanda Ramchandar, Daria Salyakina, Jennifer Foley, Christina Clarke, Toni Schwarz, Heng Xie, David Dimmock, Rita Stinnett, Benjamin Briggs, Nicole G. Coufal, Stephanie Osborne, Claudia Enriquez, Antonio Arrieta, Michelin Janvier, Lauge Farnaes, Anna S. Warden, Prithvi Sendi, Robert Schlaberg, Bryce Waldeman, Balagangadhar R. Totapally |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
encephalitis Bioinformatics DNA sequencing Major Articles law.invention 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid CSF pleocytosis law Clinical Research 030225 pediatrics medicine Genetics Pathogen Polymerase chain reaction Pediatric metagenomics business.industry Neurosciences meningitis medicine.disease Brain Disorders AcademicSubjects/MED00290 pediatric 030104 developmental biology Infectious Diseases Good Health and Well Being Oncology Metagenomics next-generation sequencing business Infection Meningitis Encephalitis |
| Zdroj: | Open forum infectious diseases, vol 8, iss 6 Open Forum Infectious Diseases |
| Popis: | Background Pediatric central nervous system (CNS) infections are potentially life-threatening and may incur significant morbidity. Identifying a pathogen is important, both in terms of guiding therapeutic management and in characterizing prognosis. Usual care testing by culture and polymerase chain reaction is often unable to identify a pathogen. We examined the systematic application of metagenomic next-generation sequencing (mNGS) for detecting organisms and transcriptomic analysis of cerebrospinal fluid (CSF) in children with central nervous system (CNS) infections. Methods We conducted a prospective multisite study that aimed to enroll all children with a CSF pleocytosis and suspected CNS infection admitted to 1 of 3 tertiary pediatric hospitals during the study timeframe. After usual care testing had been performed, the remaining CSF was sent for mNGS and transcriptomic analysis. Results We screened 221 and enrolled 70 subjects over a 12-month recruitment period. A putative organism was isolated from CSF in 25 (35.7%) subjects by any diagnostic modality. Metagenomic next-generation sequencing of the CSF samples identified a pathogen in 20 (28.6%) subjects, which were also all identified by usual care testing. The median time to result was 38 hours. Conclusions Metagenomic sequencing of CSF has the potential to rapidly identify pathogens in children with CNS infections. We examined the utility of next-generation sequencing in comparison to usual care in detecting a pathogenic organism in children with central nervous system infections. |
| Databáze: | OpenAIRE |
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