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Objective To investigate the epidemiological and clinical characteristics of 954 cases of central nervous system (CNS) infections in Chongqing. Methods A retrospective analysis was conducted on 954 patients with CNS infectious disease diagnosed and treated in the Second Affiliated Hospital of Army Medical University from 2008 to 2021. The analysis encompassed pathogens, patient gender, age of onset, time of onset, urban-rural distribution, education level, occupational distribution, and other epidemiological characteristics. The clinical manifestations, the positive rate of metagenomic next-generation sequencing (mNGS), and prognosis were also analyzed. ResultsAmong the 945 cases of CNS infectious diseases, the pathogens were viruses in 393(41.2%), Mycobacterium tuberculosis in 361(37.8%), other bacteria in 108(11.3%), Cryptococcus in 75(7.9%), Treponema pallidum in 16(1.7%) and parasites in 1(0.1%). The number of CNS infection cases from 2015 to 2021 increased by 85.6% compared with that from 2008 to 2014 (620 vs. 334, P<0.001). There was no significant difference in seasonal distribution of pathogens (P>0.05). CNS infectious diseases were more prevalent in rural areas (58.0%, P<0.001), with a male-to-female ratio of 1.7:1.0, and a higher incidence in individuals aged between 35 and 60 years. The majority of patients were educated at Junior high school level or below (68.7%) and were farmers or workers (68.1%). Clinical symptoms of CNS infectious disease mainly included fever, headache, signs of meningeal irritation, nausea and vomiting, which could be accompanied by consciousness disorder and focal neurological deficits. mNGS significantly improves the accuracy of clinical diagnosis. The rate of good prognosis of CNS infectious diseases was 97.5%, while the mortality rate was 0.3%. Conclusions In Chongqing area, the categories and species of CNS infectious pathogens are diverse, widely prevalent, and the clinical manifestations are complex. Moreover, the number of cases has been increasing in recent years. Understanding the epidemiological and clinical characteristics of CNS infectious diseases can help to recognize the regional differences, promote early accurate diagnosis and treatment, and improve prognosis.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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