Detection of Cryptococcus DNA by Metagenomic Next-generation Sequencing in Symptomatic Cryptococcal Antigenemia.
Detection of Cryptococcus DNA by Metagenomic Next-generation Sequencing in Symptomatic Cryptococcal Antigenemia.
复制标题
通过宏基因组下一代测序检测有症状的隐球菌抗原血症中的隐球菌 DNA。
DOI：
10.1093/cid/ciy1024
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Wilson,MichaelR
中科院分区：
文献类型：
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作者：
Ramachandran,PrashanthS;Cresswell,FionaV;Meya,DavidB;Langelier,Charles;Crawford,EmilyD;DeRisi,JosephL;Boulware,DavidR;Wilson,MichaelR
尽管这些数据只是来自小型试点的初步数据，但这些数据支持这样的论点，即患有脑膜炎的 HIV 血清阳性、隐球菌抗原性脑膜炎患者的一个子集可能会出现对神经侵袭性疾病的初步症状反应，而目前以标准脑脊液为重点的微生物检测却被遗漏了。我们的初步数据表明，即使丰度非常低，mNGS 也可用于检测中枢神经系统中的隐球菌。需要进行更多的大规模研究来阐明该亚组的潜在生物学原理并确定此类患者的最佳治疗方法。在此之前，我们同意作者的观点，即这些有症状的抗原血症患者表现出早期隐球菌性脑膜脑炎，因此应接受此类治疗以提高其生存率。
Though only preliminary data from a small pilot, these data support the argument that a subset of HIV-seropositive, cryptococcal-antigenemic patients with meningismus are likely presenting with an initial symptomatic response to neuroinvasive disease and are currently being missed by standard CSF-focused microbiological testing. Our preliminary data suggest the potential utility of mNGS for detection of Cryptococcus in the central nervous system, even at very low abundance. Additional largescale studies are required to clarify the underlying biology in this subgroup and to define the optimal management of such patients. Until then, we agree with the authors that these symptomatic antigenemic persons are manifesting early cryptococcal meningoencephalitis and should therefore be treated as such to improve their survival.