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Objective To investigate the effect of cerebrospinal fluid (CSF) metagenomic next - generation sequencing (mNGS) in diagnosis and treatment of intracranial infection. Methods A retrospective analysis of 117 patients with intracranial infection were admitted to Shenzhen Second People's Hospital from January 2020 to December 2022. Before initiating empirical broad - spectrum antibiotic treatment, CSF samples were collected for microbial culture (conventional culture group, n = 58) and/or mNGS (mNGS group, n = 59). The results were used to adjust the antibiotic treatment plan, and the study compared the pathogen detection rates and result reporting times of the two testing methods, as well as the antibiotic intensity grading, the intensive care unit (ICU) stay, total hospital stay, and mortality rate. Results A total of 65 pathogens were detected from the CSF samples of all the patients through microbial culture and/or mNGS, with viruses being the most prevalent, accounting for 49.23% (32/65), followed by Gram-negative bacteria (24.62%, 16/65), Gram-positive bacteria (18.46%, 12/65) and fungi (7.69%, 5/65). The pathogen detection rate of CSF mNGS was higher than that of CSF microbial culture (χ2 = 22.781, P = 0.000), and the results were reported earlier (t = - 32.588, P = 0.000). Based on the results, 20 cases (33.90%) in the mNGS group adjusted antibiotic treatment plan, with 5 cases downgrading and 15 cases upgrading the intensity of antibiotic application. In the conventional culture group, 30 cases (51.72%) adjusted their antibiotic treatment plan, with 17 cases downgrading and 13 cases upgrading the intensity of antibiotic application. There was no significant difference between the 2 groups (Z = - 1.917, P = 0.055). And there was no statistically significant difference in ICU stay (Z = - 0.716, P = 0.474）, total hospital stay (Z = - 0.933, P = 0.351) and mortality rate (Fisher's exact probability: P = 0.496) between the 2 groups. Conclusions The application of mNGS can effectively improve the detection rate of intracranial infection pathogens, which may shorten the duration of antibiotic use and reduce the intensity of broad - spectrum antibiotics, so as to help clinical effective judgment and treatment decision.

Objective To investigate the efficacy of cluster therapy in the treatment of severe intracranial infection. Methods The clinical data of 43 patients with severe intracranial infection in Shenzhen University General Hospital and Shenzhen Second People's Hospital from July 2020 to June 2023 were retrospectively analyzed. Patients with intracranial infection were treated with cluster therapy: systemic broad-spectrum antibiotics were used at first; cerebrospinal fluid was obtained by multiple drainage routes for routine and biochemical testing, and then cultured and undertook next - generation sequencing (NGS); head/chest CT and brain MRI plain and enhanced scan were performed; after the NGS results were reported, precisely adjust the drug treatment according to the infection pathogen; sequentially use different drainage protocols of infected cerebrospinal fluid. Patients with severe intraventricular inflammation were treated with ventriculoscope (flexible endoscope) irrigation and fistula; cerebrospinal fluid, microbial culture and whole blood test for infection indicators were regularly extracted for laboratory test, and the type and dosage of antibiotics were adjusted one week after the indicators returned to normal, and the treatment effect of patients was judged comprehensively according to blood, cerebrospinal fluid, imaging results and clinical signs of infection. Results Sixteen patients were administered a broad - spectrum antibiotic regimen consisting of meropenem and vancomycin. Cerebrospinal fluid analysis revealed that 12 cases (27.91%) were culture-positive for microbial organisms (bacteria, fungi, viruses), while 35 cases (81.40%) yielded positive results in NGS. Upon identification of the pathogen via NGS, 15 cases were switched to targeted, sensitive antibiotics, with 12 cases exhibiting notable improvements in symptoms, and 3 cases demonstrating no significant changes. A total of 27 patients (62.79%) underwent surgical intervention, including 7 patients (16.28%) who underwent abscess puncture drainage, 6 patients (13.95%) who received Ommaya sac implantation, 11 patients (25.58%) who underwent external ventricular drainage (8 of whom also underwent ventriculoscopic irrigation and ventriculostomy), and 3 patients (6.98%) who were treated with lumbocisterna drainage. The length of hospitalization was 30 (19, 57) d. The 37 cases (86.05%) were successfully cured, while 6 cases (13.95%) died. Conclusions The cure rate of patients with severe intracranial infection was significantly improved after cluster therapy, and early initiation of cluster therapy can significantly improve the prognosis of patients, which is worthy of clinical application.

The species diversity and temporal niche of entomopathogenic fungi community in the rhizosphere soil collected from the extensively managed Huangshan fuzz tip tea plantation were investigated. A total of 140 soil samples were collected at the location of Tangkou Town, Huangshan of Anhui Province during August, 2012 to June, 2013, and totally 1041 fungal isolates were obtained on selective medium with soil dilution plating. The results showed that the entomopathogenic fungi community in the tea plantation soil was diverse with 13 species in 6 genera. Purpureocillium lilacinum (309 strains), Beauveria bassiana (255 strains), and Metarhizium anisopliae (101 strains) were the dominant species accounting for 29. 7%, 24. 5% and 9. 7% of the relative frequency, respectively. P. lilacinum had the widest temporal niche breadth among these dominant entomopathogenic fungi from the tea plantation soil, while B. bassiana had the narrowest. Among the entomopathogenic fungi, B. bassiana and B. brongniartii had the biggest temporal niche overlap of 1. 965, while Isaria javanicus and B. bassiana had the smallest of 0. 374. [ABSTRACT FROM AUTHOR]