| Purpose:The cerebrospinal fluid nucleic acid detection method was used to summarize the sequence of pathogenic pathogens in children with central nervous system infection and analyze its characteristics,so as to provide reference for early diagnosis and treatment of clinical workers.Method:Retrospective analysis of children with central nervous system infection who were hospitalized in the Department of Pediatrics of the First Affiliated Hospital of Dali University from January 2021 to December 2022 and sent cerebrospinal fluid to the joint laboratory for nucleic acid detection.Clinical data were collected : first symptoms,age,nationality,gender,altitude of residence,first blood routine,EEG,brain CT / MRI,cerebrospinal fluid pressure,cerebrospinal fluid examination(biochemistry,routine,smear,culture),joint laboratory test for cerebrospinal fluid tuberculosis nucleic acid detection,parasite antibody detection,macrogene second-generation sequencing and multiple fluorescence quantitative PCR detection.Result:1.A total of 231 cases were diagnosed as central nervous system infection,and 164 cases were included in the perfect joint laboratory-related tests.The final clinical diagnosis was based on the final clinical diagnosis,including 117 cases of viral CNS infection(71.3 %),34 cases of bacterial CNS infection(20.7 %),9 cases of tuberculous CNS infection(5.4 %),2 cases of parasitic CNS infection(1.2 %),1 case of fungal CNS infection(0.6 %),and 1 case of viral combined bacterial CNS infection(0.6 %).2.A total of 36 positive cases were detected in 117 cases of viral CNS infection,2positive cases were detected in 65 cases using multiple fluorescence quantitative PCR,and 34 positive cases were detected in 52 cases using metagenomic next-generation sequencing.The total positive rate was 30.7 %.3.A total of 22 positive cases were detected in 34 cases of bacterial CNS,13 positive cases were detected in 24 cases using multiple fluorescence quantitative PCR,and 9 positive cases were detected in 10 cases using metagenomic next-generation sequencing.The total positive rate was 67.6 %.3.A total of 22 positive cases were detected in 34 cases of bacterial CNS infection,13 positive cases were detected in 24 cases using multiple fluorescence quantitative PCR,and 9 positive cases were detected in 10 cases using metagenomic next-generation sequencing.The total positive rate was 67.6 %.4.In 9 cases of tuberculous CNS infection,2 cases were positive for tuberculosis nucleic acid detection.Parasitic CNS infection was 2 cases of cerebral cysticercosis,and the cerebrospinal fluid parasite antibody test was negative.One case of bacterial combined with viral CNS infection was detected by metagenomics to detect K.mutans combined with HHV-7.One case of fungal CNS infection was detected by multiple fluorescence quantitative PCR.5.The main clinical manifestations were fever,convulsion and headache,followed by vomiting and diarrhea.Most patients had a recent history of respiratory tract infection.6.Bacterial CNS infection compared with viral CNS infection,blood leukocytes,C-reactive protein,cerebrospinal fluid leukocytes,cerebrospinal fluid protein increased significantly.Conclusion:1.The most common central nervous system infection in children in the northwest of Yunnan is viral CNS infection,followed by bacterial CNS infection and tuberculous CNS infection.The pathogenic bacteria of viral CNS infection are HSV-1,HHV-7,HHV-6 and CMV,and a few can be combined with two viral infections.The top three pathogens of bacterial CNS infection were Streptococcus pneumoniae,Staphylococcus epidermidis and Acinetobacter baumannii.2.The nucleic acid detection method of cerebrospinal fluid can improve the positive rate of pathogen detection in central nervous system infection,and provide reference for clinical diagnosis and treatment.3.The second-generation sequencing of metagenomics is more sensitive than fluorescence quantitative PCR in virus detection in CNS infection. |
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