Diagnostic Significance Of Targeted Next Generation Sequencing In Central Nervous System Infections In Neurosurgery Of Pediatrics

Objective: To investigate the application value of targeted next-generation sequencing in the diagnosis of central nervous system infection in neurosurgery of children.Methods: Collect the information of children aged less than 14 years who were hospitalized in the Pediatric Intensive Care Unit of the Second Hospital of Hebei Medical University between November 2018 and August2020 with suspected intracranial infection after surgical procedures retrospectively.During the treatment,routine detection,biochemical testing,smear and culture testing of cerebrospinal fluid are carried out,and clinical diagnosis is carried out according to the consensus of experts,at the same time,cerebrospinal fluid was retained for subsequent NGS sequencing.And we performed statistical analysis to the relevant data.Results:A total of 35 children were included in the study,22 with a clinical diagnosis of intracranial infection and 13 without diagnosis of intracranial infection.Among 22 children diagnosed with intracranial infection,18 positive results were detected with targeted NGS,most of which were mixed infections,including 19 species of bacteria and 5 kinds of viruses,while 3 cases of traditional culture methods were positive,all of which were bacteria.The sensitivity,specificity,positive predictive value,negative predictive value,Youden index,and area under ROC curve were 81.8%,76.9%,85.7%,71.4%,0.587,0.794(95% CI:0.629-0.958)respectively for NGS and13.6%,100%,100%,59.1%,0.136,0.568(95% CI: 0.375-0.761)respectively for traditional method.There were no statistically significance in other indicators of cerebrospinal fluid except leukocytes in both groups.Conclusions:For pediatric neurosurgical central nervous system infections,targeting NGS has good diagnostic efficacy and can be applied to the diagnosis of clinical central nervous system infections.