Evaluation of Next-Generation Sequencing for the Diagnosis of Infections of the Central Nervous System Caused by the Neurotropic Herpes Viruses: A Pilot Study

Abstract

Background: There are sparse and limited studies on small sample size reporting the application of next-generation sequencing (NGS) in the detection of central nervous system (CNS) viral infections. We assessed the diagnostic performance of NGS of cerebrospinal fluid (CSF) for predicting viral infections of the CNS caused by the neurotropic herpes viruses in a pilot population. Materials and Methods: We prospectively collected CSF samples from 24 patients with CNS viral infection from April 2017 to October 2018. Of the 24 patients, 19 patients were infected with herpes simplex virus 1 (HSV-1), 1 patient with HSV-2, and 4 patients with varicella-zoster virus (VZV). All CSF samples were screened for viral DNA using NGS technologies to detect viral CNS infections. Results: Of the 24 patients with confirmed viral CNS infection caused by the neurotropic herpes viruses, 10 (10/24, 41.67%) patients exhibited positive NGS results. With the help of NGS, HSV-1 DNA was detected in the CSF of 6 patients (6/19; 31.58%). HSV-2 DNA was detected in 1 patient (1/1; 100%) and VZV DNA was detected in 3 patients (3/4; 75%). The positive rate of virus detected by NGS decreased with time. The positive rates of NGS of CSF in the first, second, and third weeks were 54.5% (6/11), 44.4% (4/9), and 0% (0/4), respectively. Conclusions: NGS method is a promising pathogen detection tool for identifying viral CNS infections. It should be recommended to sequence viral DNA of CSF in the early stage of CNS viral infections.

Diagnostic value and clinical application of next-generation sequencing for infections in immunosuppressed patients with corticosteroid therapy

“…Effective symptomatic and antibiotic treatment could affect the diagnostic performance of both NGS and CMT. Although NGS was proved to be less likely to be affected by prior antibiotic usage than cultures (35,36), further validation of the NGS in real-world practice is still necessary. Other areas such as the impact of treatment on NGS measurement readings and whether NGS can be used as a method to assess treatment effectiveness also require further evaluation in our future studies.…”

Metagenomic Next-Generation Sequencing for Diagnosis of Infectious Encephalitis and Meningitis: A Large, Prospective Case Series of 213 Patients

“…Quality-controlled libraries were sequenced on a BGISEQ-500/50 platform (BGI-Tianjin, Tianjin, China); an average of 20 million reads was obtained for each sample. After removal of human sequences, the remaining data were aligned to bacterial, virus, fungal and protozoan databases, as described in detail elsewhere (Xing et al, 2018(Xing et al, , 2019.…”

Casos de meningite em Uberaba de 2007 a 2021: análise epidemiológica e proposta de intervenção.

“…Os enterovírus são a principal causa de meningite asséptica no mundo, seguido pelo herpes simplex vírus e influenza vírus (Sigfrid et al, 2019;Kohil et al, 2021;Steiner et al, 2010;Xing et al, 2018). Com algumas exceções, os sintomas e manifestações da doença por etiologia viral são similares aqueles causados por outros agentescomo bactérias e fungos, embora na maioria dos casos virais não há complicações severas e acometimento neurológico (Sakushima et al, 2011).…”