ArticleNature medicine2024
Seven-year performance of a clinical metagenomic next-generation sequencing test for diagnosis of central nervous system infections.
Article in Nature medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07435649 (Investigation of the Delve Detect Cerebrospinal Fluid), which is not on this map. Cited by 103 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Investigation of the Delve Detect Cerebrospinal Fluid (CSF) Metagenomic Next-generation Sequencing (mNGS) Test When Used for the Initial Diagnostic Workup of Patients With Suspected Central Nervous System (CNS) Infection
Who cites it
103 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The added value of metagenomic next-generation sequencing in central nervous system infections: a systematic review of case reports.Infection · 2025Pooled it
- Clinical metagenomics: a call to action.Intensive care medicine · 2026Article
- Machine learning models for predicting cerebrospinal fluid bacterial culture outcomes in post-neurosurgical meningitis-development and temporal three-year validation.Archives of microbiology · 2026Article
- Metagenomic next-generation sequencing in the diagnosis of viral encephalitis.World journal of virology · 2026Review
- Etiologic diagnosis of suspected tuberculous meningitis by multiplex PCR of cerebrospinal fluid.Journal of clinical microbiology · 2026Article
- Application value and challenges associated with plasma cell-free DNA metagenomic sequencing technology in the diagnosis of infections in patients with hematological disorders.Blood science (Baltimore, Md.) · 2026Review
- Metagenomic next-generation sequencing for tuberculosis diagnosis: enhanced performance and cost-effectiveness.Microbiology spectrum · 2026Observational
- Metagenomic next-generation sequencing in blood culture-negative endocarditis: a structured review with illustrative pooled estimates.Infection · 2026Review
- Masking recurrent contaminants in reference sequences improves specificity of clinical metagenomic sequencing.Journal of clinical microbiology · 2026Article
- Article
- Metagenomic next-generation sequencing for comprehensive pathogen detection in intraocular infection.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Harnessing next-generation microbial diagnostics to optimize infection management in immunocompromised hosts.Current opinion in infectious diseases · 2026Review
- Streptococcus anginosus group brain abscesses and subdural empyemas: exploratory compartment-specific phenotypes and discharge outcomes in a single-center retrospective cohort study.BMC infectious diseases · 2026Article
- Nucleosome-targeted host DNA depletion enables automated plasma metagenomic sequencing for sensitive detection of bloodstream pathogens.Journal of translational medicine · 2026Article
- Implementing portable, real-time 16S rRNA sequencing in the healthcare sector enhances antimicrobial stewardship.EBioMedicine · 2026Article
- Clinical utility of metagenomic next-generation sequencing in diagnosing spinal infections: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Review
- The Hidden Risk of Toxoplasmosis in the Expanding Immunomodulated Host Population: A Call for Guidelines and Registries in Patients on Biologics, Small Molecules, and Cellular Therapies.Pathogens (Basel, Switzerland) · 2026Article
- Empowering One Health with metagenomics.One health outlook · 2026Review
- Letter to the Editor: Dengue virus as an underrecognized cause of encephalitis in tropical Asia - Bridging diagnostic and surveillance gaps.World journal of virology · 2026Article
- Candida tropicalis Brain Abscess Diagnosed by Metagenomic Next-generation Sequencing.Internal medicine (Tokyo, Japan) · 2026Article
43 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors.
Funding
Abstract
Metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) is an agnostic method for broad-based diagnosis of central nervous system (CNS) infections. Here we analyzed the 7-year performance of clinical CSF mNGS testing of 4,828 samples from June 2016 to April 2023 performed by the University of California, San Francisco (UCSF) clinical microbiology laboratory. Overall, mNGS testing detected 797 organisms from 697 (14.4%) of 4,828 samples, consisting of 363 (45.5%) DNA viruses, 211 (26.4%) RNA viruses, 132 (16.6%) bacteria, 68 (8.5%) fungi and 23 (2.9%) parasites. We also extracted clinical and laboratory metadata from a subset of the samples (n = 1,164) from 1,053 UCSF patients. Among the 220 infectious diagnoses in this subset, 48 (21.8%) were identified by mNGS alone. The sensitivity, specificity and accuracy of mNGS testing for CNS infections were 63.1%, 99.6% and 92.9%, respectively. mNGS testing exhibited higher sensitivity (63.1%) than indirect serologic testing (28.8%) and direct detection testing from both CSF (45.9%) and non-CSF (15.0%) samples (P < 0.001 for all three comparisons). When only considering diagnoses made by CSF direct detection testing, the sensitivity of mNGS testing increased to 86%. These results justify the routine use of diagnostic mNGS testing for hospitalized patients with suspected CNS infection.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.