![]() neoformans in clinical specimens.Ĭulture of cerebrospinal fluid (CSF) is the “gold standard” for the diagnosis of cryptococcal meningitis (CM) ( Perfect et al., 2010), a serious opportunistic fungal infection caused by Cryptococcus neoformans or Cryptococcus gattii, with novel cases of Papiliotrema laurentii and Naganishia albida ( Khawcharoenporn et al., 2007 Smith et al., 2017), but it has poor timeliness and low positivity rate for patients receiving antifungal drugs. gattii of the 3 cases was only distinguished by mNGS.Ĭonclusions: CSF mNGS can be considered as a supplementary test to diagnose CM and directly distinguish C. It should be noted that mNGS could identify Cryptococcus at species level C. Besides, mNGS had a sensitivity of 100.0% against culture. Comparing to the conventional diagnostic methods, the sensitivity and concordance rate of mNGS were slightly lower than those of CrAg tests (97.4%) but higher than those of India ink (63.0%) and culture (76.7%). The sensitivity, specificity, positive predictive value, negative predictive value, and concordance rate of mNGS were 93.5%, 96.0% (95% CI at 92.9%~99.1%), 87.8%, 98.0%, and 95.4%, respectively. Results: Of the 197 enrolled cases, 46 (23.4%) cases were finally diagnosed with CM, including 43 (93.5%) Cryptococcus neoformans infections and 3 (6.5%) Cryptococcus gattii infections. Methods: Cerebrospinal fluid (CSF) samples from 197 HIV-negative patients with suspected central nervous system infections were tested simultaneously by mNGS and routine methods. Objectives: Metagenomic next-generation sequencing (mNGS) has been applied more and more widely for the diagnosis of infectious diseases, but its performance in the diagnosis of cryptococcal meningitis (CM) remains unclear. 2Department of Scientific Affairs, Hugobiotech Co., Ltd., Beijing, China.1Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.Zhouqing Gan 1†, Jia Liu 1†, Yijie Wang 1, Lu Yang 1, Zheng Lou 2, Han Xia 2, Min Li 1, Zhuolin Chen 1, Ying Jiang 1* and Fuhua Peng 1*
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