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Войти в исследования Diagnostic microbiology and infectious disease · 2026
Construction of a "three-stage and four-level" evaluation system for cerebrospinal fluid pathogens based on mNGS: insights from a case of co-detection of Cryptococcus and Epstein-barr virus.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
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Que Hongfang, Jiang Xiaorong, Wu Xianbin, Li Shaochi
Аннотация
BACKGROUND: Metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) has brought about a revolutionary change in the diagnosis of central nervous system (CNS) infections. Nevertheless, the interpretation of results with multiple detected pathogens still poses a substantial clinical challenge.
AIM: A preliminary exploration of the application value of the developed "Three-Stage, Four-Level" assessment system in interpreting mNGS cerebrospinal fluid test reports.
METHODS: Based on a systematic review of relevant domestic and international literature, combined with practical experience in the field, a multi-dimensional "Three-Stage, Four-Level" evaluation system centered on a clinical-microbiological evidence chain was constructed. This study explores the application value of the system through a case of mNGS detection for co-preservation of Cryptococcus and Epstein-Barr virus (EBV) in cerebrospinal fluid (CSF).
RESULTS: The system effectively integrated multi-source information, facilitating a precise and stratified interpretation of CSF mNGS results. It successfully differentiated Cryptococcus as the pathogenic agent and EBV as a latent pathogen. Consequently, early antifungal therapy was initiated, resulting in a gradual improvement of symptoms and a favorable prognosis.
CONCLUSION: This case initially demonstrates that the "Three-Stage,Four-Level "evaluation system provides a standardized and operational framework for interpreting mNGS cerebrospinal fluid multiplex pathogen detection results, showing preliminary value in precisely distinguishing pathogen types; however, further validation with larger sample sizes is warranted.
AIM: A preliminary exploration of the application value of the developed "Three-Stage, Four-Level" assessment system in interpreting mNGS cerebrospinal fluid test reports.
METHODS: Based on a systematic review of relevant domestic and international literature, combined with practical experience in the field, a multi-dimensional "Three-Stage, Four-Level" evaluation system centered on a clinical-microbiological evidence chain was constructed. This study explores the application value of the system through a case of mNGS detection for co-preservation of Cryptococcus and Epstein-Barr virus (EBV) in cerebrospinal fluid (CSF).
RESULTS: The system effectively integrated multi-source information, facilitating a precise and stratified interpretation of CSF mNGS results. It successfully differentiated Cryptococcus as the pathogenic agent and EBV as a latent pathogen. Consequently, early antifungal therapy was initiated, resulting in a gradual improvement of symptoms and a favorable prognosis.
CONCLUSION: This case initially demonstrates that the "Three-Stage,Four-Level "evaluation system provides a standardized and operational framework for interpreting mNGS cerebrospinal fluid multiplex pathogen detection results, showing preliminary value in precisely distinguishing pathogen types; however, further validation with larger sample sizes is warranted.