Nanopore <scp>16S</scp> sequencing enhances the detection of bacterial meningitis after neurosurgery

Jang, Yoonhyuk; Kim, Seondeuk; Kim, Na-Rae; Son, Hyoshin; Ha, Eun Jin; Koh, Eun Jung; Park, Chul‐Kee; Kim, Jeong Eun; Kim, Seung‐Ki; Lee, Sang Kun; Cho, Won Sang; Moon, Jangsup; Chu, Kon

doi:10.1002/acn3.51517

Cited by 13 publications

(6 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study demonstrated the potential of 16S rRNA gene PCR/sequencing (30% of tested, culture negative CSF samples were positive) that can identify the presence of bacteria even in patients who have already received antibiotics [ 14 , 15 , 16 ]. This method can also provide more rapid identification, especially of slow-growing and fastidious bacteria [ 17 , 18 ]. Multiple studies on broad range PCR methods in HCAMV report high specificity and often limited sensitivity [ 19 , 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Etiology and Outcomes of Healthcare-Associated Meningitis and Ventriculitis—A Single Center Cohort Study

Panić

Gjurašin

Santini

et al. 2022

Infectious Disease Reports

View full text Add to dashboard Cite

Healthcare associated meningitis and ventriculitis (HCAMV) are serious complications of neurosurgical procedures. We conducted a retrospective cohort study of patients with HCAMV treated at the University Hospital for Infectious Diseases Zagreb during the 2013–2019 period. A total of 144 patients with 151 episodes of HCAMV were included. The most common indications for neurosurgical procedures were brain tumor, hemorrhage and hydrocephalus. Etiology was identified in 90 (59.6%) episodes (either positive CSF culture or positive PCR), and in other 61 (40.39%) the diagnosis of HCAMV was made based on clinical and CSF parameters, without microbiologic confirmation. Carbapenem-resistant Acinetobacter baumannii was the most common pathogen (15.89%), followed by Staphylococcus aureus (13.91%), Pseudomonas aeruginosa (13.25%) and Coagulase negative staphylococci (7.95%). Overall, 24 (16.3%) patients died, and the majority had adverse outcomes, persistent vegetative state (8, 5.56%) and severe disability (31, 21.53%). The worst clinical outcomes were observed in A. baumannii infections. High rate of complications, the need for external ventricular drainage (re)placement often complicated with nosocomial infections and prolonged stay in intensive care units were observed. Clinicians should be aware of local microbial epidemiology on guiding proper empirical antimicrobial treatment in patients with HCAMV.

show abstract

Section: Discussionmentioning

confidence: 99%

Etiology and Outcomes of Healthcare-Associated Meningitis and Ventriculitis—A Single Center Cohort Study

Panić

Gjurašin

Santini

et al. 2022

Infectious Disease Reports

View full text Add to dashboard Cite

show abstract

“…Due to the strong capacity of pathogen detection, NTS should be recommended to be used in CSF for diagnosing CNS infection. Supporting our view, a pilot study including six retrospective cases of confirmed bacterial meningitis and two prospective cases showed that the NTS was more sensitive than conventional culture and worked properly even in samples exposed to antibiotics ( 25 ). Another study showed that the diagnostic sensitivity of the NTS and culture was 100% and 44.9%, respectively, for the genuine CNS infection ( 26 ).…”

Section: Discussionmentioning

confidence: 72%

A prospective study of nanopore-targeted sequencing in the diagnosis of central nervous system infections

Fu,

Gu,

Chen

et al. 2024

Microbiol Spectr

View full text Add to dashboard Cite

Central nervous system (CNS) infections are a leading cause of death in patients. Nanopore-targeted sequencing (NTS) has begun to be used for pathogenic microbial detection. This study aims to evaluate the ability of NTS in the detection of pathogens in cerebrospinal fluid (CSF) through a prospective study. Fifty CSF specimens collected from 50 patients with suspected CNS infections went through three methods including NTS, metagenomic next-generation sequencing (mNGS), and microbial culture in parallel. When there was an inconsistency between NTS results and the results of the mNGS, the 16S rDNA gene was amplified followed by Sanger sequencing to further verify pathogens detected by NTS. Among 50 CSF specimens, 76% were NTS-positive, which is lower than mNGS (94.0%), yet higher than microbial culture (16.0%). The overall validation rate, diagnostic accordance rate (DAR), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of NTS were 86.7%, 50.0%, 71.0%, 15.8%, 57.9%, and 25.0%, respectively. In the CSF total nucleated cell (TNC) number ≤10 cells/µL, DAR, specificity, and PPV were 20%, 11.1%, and 11.1%, whereas in that with CSF TNC number >10 cells/µL, DAR, sensitivity, specificity, PPV, and NPV were 57.5%, 70.0%, 20.0%, 72.4%, and 18.2%, respectively. Although NTS has a higher microbial detection rate than microbial culture, it should combine CSF TNC result to evaluate the value of NTS for the diagnosis of CNS infections. IMPORTANCE This study aims to prospectively evaluate the ability of nanopore-targeted sequencing (NTS) in the detection of pathogens in cerebrospinal fluid (CSF). It was the first time combining mNGS and microbial culture to verify the NTS-positive results also using 16S rDNA amplification with Sanger sequencing. Although microbial culture was thought to be the gold standard for pathogens detection and diagnosis of infectious diseases, this study suggested that microbial culture of CSF is not the most appropriate way for diagnosing central nervous system (CNS) infection. NTS should be recommended to be used in CSF for diagnosing CNS infection. When evaluating the value of NTS for diagnosis of CNS infections, the results of CSF TNC should be combined, and NTS-positive result is observed to be more reliable in patients with CSF TNC level >10 cells/μL.

show abstract

“…Cerebrospinal fluid (CSF) analysis is currently considered the gold standard for diagnosing intracranial infections, and biomarkers such as CSF lactate, heparin-binding protein, C-reactive protein, and procalcitonin play ancillary roles [ 46 – 49 ]. With the development of molecular biology, laboratory diagnostic tools have evolved from the cellular to the molecular DNA levels [ 50 , 51 ]. Pathogenic high-throughput genetic testing enables the rapid detection of disease-causing microorganisms.…”

Section: Literature Review and Discussionmentioning

confidence: 99%

Rare post-operative intracranial abscess due to Serratia marcescens: what we can learn from it?

Liu,

Feng,

Song

et al. 2024

BMC Infect Dis

View full text Add to dashboard Cite

Background Nosocomial infections caused by Serratia marcescens mostly occurred in pediatrics and it was very rarely reported after adult surgery. Here, an intracranial abscess caused by Serratia marcescens was reported. Case summary We report a rare case of a postoperative intracranial abscess caused by Serratia marcescens in a 63-year-old male patient with a left parietal mass. The patient underwent resection of the mass on June 1, 2022, and the postoperative pathology revealed an angiomatous meningioma, WHO I. He then experienced recurrent worsening of right limb movements, and repeated cranial CT scans showed oozing blood and obvious low-density shadows around the operation area. Delayed wound healing was considered. Subsequently, a large amount of pus was extracted from the wound. The etiological test showed that Serratia marcescens infection occurred before the removal of the artificial titanium mesh. Antibiotics were initiated based on the results of drug susceptibility tests. At present, the patient is recovering well and is still closely monitored during follow-up. Conclusion It is rare for Serratia marcescens to cause brain abscesses without any obvious signs of infection. This report provided in detail our experience of a warning postoperative asymptomatic brain abscess caused by an uncommon pathogen.

show abstract

Nanopore 16S sequencing enhances the detection of bacterial meningitis after neurosurgery

Cited by 13 publications

References 42 publications

Etiology and Outcomes of Healthcare-Associated Meningitis and Ventriculitis—A Single Center Cohort Study

Etiology and Outcomes of Healthcare-Associated Meningitis and Ventriculitis—A Single Center Cohort Study

A prospective study of nanopore-targeted sequencing in the diagnosis of central nervous system infections

Rare post-operative intracranial abscess due to Serratia marcescens: what we can learn from it?

Contact Info

Product

Resources

About