PMID- 34595132 OWN - NLM STAT- MEDLINE DCOM- 20211019 LR - 20211019 IS - 2235-2988 (Electronic) IS - 2235-2988 (Linking) VI - 11 DP - 2021 TI - Metagenomic Next Generation Sequencing in the Detection of Pathogens in Cerebrospinal Fluid of Patients After Alternative Donor Transplantation: A Feasibility Analysis. PG - 720132 LID - 10.3389/fcimb.2021.720132 [doi] LID - 720132 AB - Central nervous system (CNS) complications can occur in 9%-15% of patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The clinical manifestations of the CNS complications are non-specific, with most of them being disturbances of consciousness, convulsions, headaches, fever, and epilepsy, making it difficult to infer the cause of the complications based on clinical manifestations. We retrospectively analyzed the sensitivity and feasibility of metagenomic next generation sequencing (mNGS) in the diagnosis of CNS infections after allo-HSCT. Lumbar punctures were performed on 20 patients with CNS symptoms after receiving alternative donor HSCT(AD-HSCT) at the Affiliated Cancer Hospital of Zhengzhou University from February 2019 to December 2020, and their cerebrospinal fluid (CSF) was collected. The mNGS technique was used to detect pathogens in the CSF. Routine CSF testing, biochemical analyses, G experiments, GM experiments, ink staining, acid-fast staining, and bacterial cultures were carried out, and quantitative PCR (qPCR) tests were used to detect cytomegalovirus (CMV), Epstein-Barr virus (EBV), BK polyomavirus (BKPyV), and human alphaherpesvirus (HHV). A total of 29 tests were performed with 21 of them being positive. Of the five negative patients, three were diagnosed with a posterior reversible encephalopathy syndrome, one as having transplantation-associated thrombotic microangiopathy, and one with transient seizure caused by hypertension. Fifteen patients tested positive, of which four had single infections and eleven had mixed infections. Five cases of fungal infections, six cases of bacterial infections, and 13 cases of viral infections were detected. Among the 13 cases of viral infections, ten cases were CMV(HHV-5); three were BKPyV; two were Torque teno virus (TTV); Two were HHV-1,two were EBV(HHV4), and one each of HpyV5 and HHV-6B. Thirteen patients tested positive for virus while the qPCR detection method of 6 identical specimens were below the minimum detection limit(<1x10(3) U/ml). The mNGS technique is highly sensitive, and it can be used to diagnose CNS infections after allo-HSCT. CI - Copyright (c) 2021 Zhang, Zhou, Gui, Li, Zu, Wang, Yu, Zhang, Zhao, Ji and Song. FAU - Zhang, Binglei AU - Zhang B AD - School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China. AD - Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China. AD - Henan Academy of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China. AD - Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China. FAU - Zhou, Jian AU - Zhou J AD - Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China. FAU - Gui, Ruirui AU - Gui R AD - Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China. FAU - Li, Zhen AU - Li Z AD - Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China. FAU - Zu, Yingling AU - Zu Y AD - Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China. FAU - Wang, Juan AU - Wang J AD - Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China. FAU - Yu, Fengkuan AU - Yu F AD - Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China. FAU - Zhang, Yanli AU - Zhang Y AD - Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China. FAU - Zhao, Huifang AU - Zhao H AD - Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China. FAU - Ji, Zhenyu AU - Ji Z AD - Henan Academy of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China. FAU - Song, Yongping AU - Song Y AD - Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210914 PL - Switzerland TA - Front Cell Infect Microbiol JT - Frontiers in cellular and infection microbiology JID - 101585359 SB - IM MH - *Epstein-Barr Virus Infections MH - Feasibility Studies MH - Herpesvirus 4, Human/genetics MH - High-Throughput Nucleotide Sequencing MH - Humans MH - *Posterior Leukoencephalopathy Syndrome MH - Retrospective Studies PMC - PMC8476959 OTO - NOTNLM OT - alternative donor OT - cerebrospinal fluid OT - hematopoietic stem cell transplantation OT - metagenomics next generation sequencing (mNGS) OT - pathogen COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2021/10/02 06:00 MHDA- 2021/10/21 06:00 PMCR- 2021/01/01 CRDT- 2021/10/01 07:35 PHST- 2021/06/03 00:00 [received] PHST- 2021/08/20 00:00 [accepted] PHST- 2021/10/01 07:35 [entrez] PHST- 2021/10/02 06:00 [pubmed] PHST- 2021/10/21 06:00 [medline] PHST- 2021/01/01 00:00 [pmc-release] AID - 10.3389/fcimb.2021.720132 [doi] PST - epublish SO - Front Cell Infect Microbiol. 2021 Sep 14;11:720132. doi: 10.3389/fcimb.2021.720132. eCollection 2021.