Observational studyJournal of clinical microbiology2024
A retrospective observational study of mNGS test utilization to examine the role of diagnostic stewardship at two academic medical centers.
Observational study in Journal of clinical microbiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed.
- Clinical utility of metagenomic next-generation sequencing in precision diagnosis of infectious diseases: a retrospective study based on bronchoalveolar lavage fluid, blood, and cerebrospinal fluid.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Impact of direct from clinical sample sequencing assays for infectious diseases diagnostics: A single-centre retrospective cohort study.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2026Article
- Evaluation of the Ultima Genomics UG 100 sequencer for low-cost, high-sensitivity metagenomic pathogen detection from cerebrospinal fluid.Microbiology spectrum · 2026Article
- Fungal diagnostic stewardship in immunocompromised populations: a focus on molds and dimorphic fungi.Clinical microbiology reviews · 2026Review
- DisseminatedASM case reports · 2026Article
- Clinical utility of CSF metagenomic next-generation sequencing in suspected CNS infection: performance against a composite reference standard and read-count stratification.Frontiers in cellular and infection microbiology · 2026Article
- Refining the Clinical Utility of Plasma Microbial Cell-Free DNA Sequencing in High-Risk Population of Infection: A Narrative Review.Infection and drug resistance · 2026Review
- Cell-free DNA metagenomic next generation sequencing for the diagnosis of infectious diseases: a retrospective assessment of clinical utility in a tertiary and quaternary care facility.Frontiers in microbiology · 2026Article
- Application of metagenomic next-generation sequencing technology in hematologic malignancy patients with sepsis following antibiotic use.BMC infectious diseases · 2025Article
- Next-Generation Sequencing for Bloodstream Infections: Shaping the Future of Rapid Diagnostics and Precision Medicine.Diagnostics (Basel, Switzerland) · 2025Review
- Article
- Recent advances in diagnostic technologies for postoperative central nervous system infections: a review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Review
- Use and Stewardship of Molecular Testing for Diagnosis of Infectious Diseases: A Cross-Sectional Survey.Journal of the Pediatric Infectious Diseases Society · 2025Article
- Metagenomic Next-Generation Sequencing in Infectious Diseases: Clinical Applications, Translational Challenges, and Future Directions.Diagnostics (Basel, Switzerland) · 2025Review
- Clinical application of metagenomic next-generation sequencing in the diagnosis of severe pneumonia pathogens.Frontiers in cellular and infection microbiology · 2025Article
- Yield of clinical metagenomics: insights from real-world practice for tissue infections.EBioMedicine · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Given the cost and unclear clinical impact of metagenomic next-generation sequencing (mNGS), laboratory stewardship may improve utilization. This retrospective observational study examines mNGS results from two academic medical centers employing different stewardship approaches. Eighty mNGS orders [54 cerebrospinal fluid (CSF) and 26 plasma] were identified from 2019 to 2021 at the University of Washington (UW), which requires director-level approval for mNGS orders, and the University of Utah (Utah), which does not restrict ordering. The impact of mNGS results and the relationship to traditional microbiology orders were evaluated. Nineteen percent (10/54) of CSF and 65% (17/26) of plasma studies detected at least one organism. Compared to CSF results, plasma results more frequently identified clinically significant organisms (31% vs 7%) and pathogens not detected by traditional methods (12% vs 0%). Antibiotic management was more frequently impacted by plasma versus CSF results (31% vs 4%). These outcome measures were not statistically different between study sites. The number and cumulative cost of traditional microbiology tests at UW were greater than Utah for CSF mNGS testing (UW: 46 tests, $6,237; Utah: 26 tests, $2,812; IMPORTANCE: Metagenomic next-generation sequencing (mNGS) stewardship practices remain poorly standardized. This study aims to provide actionable insights for institutions that seek to reduce the unnecessary usage of mNGS. Importantly, we highlight that clinical impact remains challenging to measure without standardized guidelines, and we provide an actual cost estimate of microbiology expenditures on individuals undergoing mNGS.
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