Study on value of cerebrospinal fluid biochemical indicators combined with NGS on detecting and diagnosing postoperative intracranial infection in patients with craniocerebral injury
Objective To explore the diagnostic value of cerebrospinal fluid biochemical indicators combined with next generation sequencing(NGS)on postoperative intracranial infection in patients with craniocerebral injury.Methods Patients with craniocerebral injury after surgery in the Meishan Hospital of Traditional Chinese Medicine from January 2019 to March 2021 were selected and divided into intracranial infection group(19 cases)and non-intracranial infection group(216 cases)according to whether the patients were complicated with postoperative intracranial infection.Cerebrospinal fluid C-reactive protein(CRP)and procalcitonin(PCT)levels were detected,and pathogens were detected by NGS and bacterial culture,respectively.The diagnostic value of cerebrospinal fluid biochemical indicators combined with NGS on postoperative intracranial infection in patients with craniocerebral injury was analyzed.Results National Institute of Health Stroke Scale(NIHSS)score in intracranial infection group was higher than that in non-intracranial infection group(t=7.166,P＜0.05).The levels of CRP and PCT in cerebrospinal fluid in intracranial infection group were higher compared with those in non-intracranial infection group(t=11.745,6.803;all P＜0.05).20 cases(8.51％)of intracranial infection after craniocerebral injury were positive and 215 cases(91.49％)were negative by NGS detection,of which 16 cases(6.81％)were true positive and 212 cases(90.21)were true negative,and the Kappa value of NGS in the diagnosis of intracreanial infection after craniocerebral injury was 0.804.The main pathogen of 19 patients with intracranial infection was coagulase negative staphylococcus(11/19,57.89％),followed by Enterococcus faecalis(4/19,21.05％).Receiver operating characteristic(ROC)curve analysis results showed that the area under the curve(AUC)of cerebrospinal fluid CRP,PCT and NGS were 0.904,0.915 and 0.912,and the sensitivities were 89.47％,89.50％and 84.21％,and the specificities were 81.02％,83.30％and 98.15％,respectively.The cut-off values of cerebrospinal fluid CRP and PCT were 42.12 mg/L and 1.39 ng/L,respectively.The AUC of combined diagnosis was 0.986,which was greater than that of each single indicator(P＜0.05).Conclusion Cerebrospinal fluid biochemical indicators combined with NGS had certain diagnostic value on postoperative intracranial infection in patients with craniocerebral injury,and should worth popularizing and applying.
After craniocerebral injury surgeryIntracranial infectionNext generation sequencingCerebrospinal fluidBiochemical indicators
NETL
NSTL
万方数据
