ArticleBMC infectious diseases2023
Early application of metagenomics next-generation sequencing may significantly reduce unnecessary consumption of antibiotics in patients with fever of unknown origin.
Article in BMC infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 16 citations in OpenAlex.
- Effects of a clinical metagenomics intervention on clinical outcomes, healthcare costs, and health-related quality of life in patients with sepsis or septic shock: results of the randomized-controlled DigiSep trial.Intensive care medicine · 2026Trial
- Article
- State-of-the-Art Review: Contemporary Ambulatory Approach to Adult Fever of Unknown Origin.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Review
- Clinical characteristics of sporadic acute Q fever diagnosed by metagenomic next-generation sequencing: a retrospective analysis and literature review in China.BMC infectious diseases · 2026Review
- When cough leads to infarction: systemic arterial embolism as a sentinel complication of insidious pulmonary mucormycosis in an immunocompetent patient.BMC pulmonary medicine · 2026Article
- Institutional Readiness and Diagnostic Challenges for the Management of Pyrexia of Unknown Origin (PUO) in Nepal: A Mixed-Methods Study at Tertiary Level Hospitals.Research square · 2026Article
- Enhancing infection diagnostics in advanced chronic liver disease: harnessing clinical metagenomics for rapid pathogen and antimicrobial resistance detection.npj antimicrobials and resistance · 2026Review
- The value of metagenomic next-generation sequencing in the diagnosis of fever of unknown origin.Scientific reports · 2025Article
- Diagnostic utility of metagenomic next-generation sequencing for tissue in patients with suspected infectious diseases.Frontiers in cellular and infection microbiology · 2025Article
- Emergence, persistence, and positive selection of yellow fever virus in Colombia.Frontiers in microbiology · 2025Article
- Recommendations for Updating Fever and Inflammation of Unknown Origin From a Modified Delphi Consensus Panel.Open forum infectious diseases · 2024Article
- A single-center, retrospective study of hospitalized patients with lower respiratory tract infections: clinical assessment of metagenomic next-generation sequencing and identification of risk factors in patients.Respiratory research · 2024Article
- Metagenomic next-generation sequencing of plasma cell-free DNA improves the early diagnosis of suspected infections.BMC infectious diseases · 2024Article
- The role of metagenomic next-generation sequencing in diagnosing and managing post-kidney transplantation infections.Frontiers in cellular and infection microbiology · 2024Review
- Update on Fever of Unknown Origin in Children: Focus on Etiologies and Clinical Approach.Children (Basel, Switzerland) · 2023Review
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundMetagenomic next-generation sequencing (mNGS) is a novel nucleic acid method for the detection of unknown and difficult pathogenic microorganisms, and its application in the etiological diagnosis of fever of unknown origin (FUO) is less reported. We aimed to comprehensively assess the value of mNGS in the etiologic diagnosis of FUO by the pathogen spectrum and diagnostic performance, and to investigate whether it is different in the time to diagnosis, length of hospitalization, antibiotic consumption and cost between FUO patients with and without early application of mNGS.
methodsA total of 149 FUO inpatients underwent both mNGS and routine pathogen detection was retrospectively analyzed. The diagnostic performance of mNGS, culture and CMTs for the final clinical diagnosis was evaluated by using sensitivity, specificity, positive predictive value, negative predictive value and total conforming rate. Patients were furtherly divided into two groups: the earlier mNGS detection group (sampling time: 0 to 3 days of the admission) and the later mNGS detection group (sampling time: after 3 days of the admission). The length of hospital stay, time spent on diagnosis, cost and consumption of antibiotics were compared between the two groups.
resultsCompared with the conventional microbiological methods, mNGS detected much more species and had the higher negative predictive (67.6%) and total conforming rate (65.1%). Patients with mNGS sampled earlier had a significantly shorter time to diagnosis (6.05+/-6.23 vs. 10.5+/-6.4 days, P < 0.001) and days of hospital stay (13.7+/-20.0 vs. 30.3 +/-26.9, P < 0.001), as well as a significantly less consumption (13.3+/-7.8 vs. 19.5+/-8.0, P < 0.001) and cost (4543+/-7326 vs. 9873 +/- 9958 China Yuan [CNY], P = 0.001) of antibiotics compared with the patients sampled later.
conclusionsmNGS could significantly improve the detected pathogen spectrum, clinical conforming rate of pathogens while having good negative predictive value for ruling out infections. Early mNGS detection may shorten the diagnosis time and hospitalization days and reduce unnecessary consumption of antibiotics.
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