Comparison of mNGS with conventional methods for diagnosis of cryptococcal meningitis: a retrospective study
Abstract The application of metagenomic next-generation sequencing (mNGS) in the diagnosis of cryptococcal meningitis is relatively under characterized. Here, we retrospectively evaluated data from cryptococcal meningitis patients who were tested using mNGS and/or routine testing, including fungal c...
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Nature Portfolio
2025-01-01
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| author | Zai-Jie Jiang Jian-Chen Hong Bi-Wei Lin Wei-Qing Zhang Qi-Chao Fan Bi-Hui Yang Xiang-Ping Yao |
| author_facet | Zai-Jie Jiang Jian-Chen Hong Bi-Wei Lin Wei-Qing Zhang Qi-Chao Fan Bi-Hui Yang Xiang-Ping Yao |
| author_sort | Zai-Jie Jiang |
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| description | Abstract The application of metagenomic next-generation sequencing (mNGS) in the diagnosis of cryptococcal meningitis is relatively under characterized. Here, we retrospectively evaluated data from cryptococcal meningitis patients who were tested using mNGS and/or routine testing, including fungal culture, India ink staining, and cryptococcal antigen (CrAg) testing. The performance of mNGS was then assessed. Initial cerebrospinal fluid (CSF) samples were collected from 65 patients with suspected central nervous system (CNS) infection and tested using conventional tests and/or mNGS. mNGS offers a culture-independent approach, facilitating a rapid and unbiased detection of a broad spectrum of pathogens. Patients with bacterial tuberculous or viral meningitis were used as mNGS-positive controls and one autoimmune encephalitis patient was used as an mNGS-negative control. In the 45 patients diagnosed with cryptococcal meningitis, the sensitivity, specificity, positive predictive value, negative predictive value, and concordance rate of mNGS were 92%, 100%, 100%, 90.9%, and 95.6%, respectively. Compared to conventional methods, the sensitivity of mNGS was slightly lower than CrAg tests (96.7%) but higher than India ink (79.5%) and culturing (63.4%). Of the two negative mNGS cases (2/25, 8.0%), one was positive by India ink staining, culture, and CrAg testing, while the other was positive only by CrAg testing. A combination of mNGS and conventional methods enhanced the detection rate to 100%. Our study demonstrates that both CrAg and mNGS offer excellent diagnostic accuracy for cryptococcal meningitis, and utilizing both tests can enhance clinical assessment and patient management. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-985a247842d14882a7fb082d833a31502025-02-02T12:17:10ZengNature PortfolioScientific Reports2045-23222025-01-0115111210.1038/s41598-025-86481-2Comparison of mNGS with conventional methods for diagnosis of cryptococcal meningitis: a retrospective studyZai-Jie Jiang0Jian-Chen Hong1Bi-Wei Lin2Wei-Qing Zhang3Qi-Chao Fan4Bi-Hui Yang5Xiang-Ping Yao6Fujian Key Laboratory of Molecular Neurology, Department of Neurology, Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Medical UniversityDepartment of Gastrointestinal Surgery, The First Affiliated Hospital, Fujian Medical UniversityFujian Key Laboratory of Molecular Neurology, Department of Neurology, Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Medical UniversityDepartment of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical UniversityDepartment of Infectious Disease, The First Affiliated Hospital, Fujian Medical UniversityFujian Key Laboratory of Molecular Neurology, Department of Neurology, Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Medical UniversityFujian Key Laboratory of Molecular Neurology, Department of Neurology, Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Medical UniversityAbstract The application of metagenomic next-generation sequencing (mNGS) in the diagnosis of cryptococcal meningitis is relatively under characterized. Here, we retrospectively evaluated data from cryptococcal meningitis patients who were tested using mNGS and/or routine testing, including fungal culture, India ink staining, and cryptococcal antigen (CrAg) testing. The performance of mNGS was then assessed. Initial cerebrospinal fluid (CSF) samples were collected from 65 patients with suspected central nervous system (CNS) infection and tested using conventional tests and/or mNGS. mNGS offers a culture-independent approach, facilitating a rapid and unbiased detection of a broad spectrum of pathogens. Patients with bacterial tuberculous or viral meningitis were used as mNGS-positive controls and one autoimmune encephalitis patient was used as an mNGS-negative control. In the 45 patients diagnosed with cryptococcal meningitis, the sensitivity, specificity, positive predictive value, negative predictive value, and concordance rate of mNGS were 92%, 100%, 100%, 90.9%, and 95.6%, respectively. Compared to conventional methods, the sensitivity of mNGS was slightly lower than CrAg tests (96.7%) but higher than India ink (79.5%) and culturing (63.4%). Of the two negative mNGS cases (2/25, 8.0%), one was positive by India ink staining, culture, and CrAg testing, while the other was positive only by CrAg testing. A combination of mNGS and conventional methods enhanced the detection rate to 100%. Our study demonstrates that both CrAg and mNGS offer excellent diagnostic accuracy for cryptococcal meningitis, and utilizing both tests can enhance clinical assessment and patient management.https://doi.org/10.1038/s41598-025-86481-2Metagenomic next-generation sequenceConventional methodCryptococcal meningitisDiagnosisCerebrospinal fluid |
| spellingShingle | Zai-Jie Jiang Jian-Chen Hong Bi-Wei Lin Wei-Qing Zhang Qi-Chao Fan Bi-Hui Yang Xiang-Ping Yao Comparison of mNGS with conventional methods for diagnosis of cryptococcal meningitis: a retrospective study Scientific Reports Metagenomic next-generation sequence Conventional method Cryptococcal meningitis Diagnosis Cerebrospinal fluid |
| title | Comparison of mNGS with conventional methods for diagnosis of cryptococcal meningitis: a retrospective study |
| title_full | Comparison of mNGS with conventional methods for diagnosis of cryptococcal meningitis: a retrospective study |
| title_fullStr | Comparison of mNGS with conventional methods for diagnosis of cryptococcal meningitis: a retrospective study |
| title_full_unstemmed | Comparison of mNGS with conventional methods for diagnosis of cryptococcal meningitis: a retrospective study |
| title_short | Comparison of mNGS with conventional methods for diagnosis of cryptococcal meningitis: a retrospective study |
| title_sort | comparison of mngs with conventional methods for diagnosis of cryptococcal meningitis a retrospective study |
| topic | Metagenomic next-generation sequence Conventional method Cryptococcal meningitis Diagnosis Cerebrospinal fluid |
| url | https://doi.org/10.1038/s41598-025-86481-2 |
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