ArticleJournal of translational medicine2025
Impact of metagenomics next-generation sequencing on etiological diagnosis and early outcomes in sepsis.
Article in Journal of translational medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Review
- Enhancing infection diagnostics in advanced chronic liver disease: harnessing clinical metagenomics for rapid pathogen and antimicrobial resistance detection.npj antimicrobials and resistance · 2026Review
- Complementary mNGS and traditional testing for bloodstream infections.Open medicine (Warsaw, Poland) · 2026Review
- Case Report: A rare case of Pneumocystis jirovecii infection with left hydropneumothorax following immunotherapy for stage IVB clear cell renal cell carcinoma.Frontiers in medicine · 2026Article
- Case Report: Beyond conventional diagnostics: mNGS support in a complex immunocompromised patient diagnosis.Frontiers in medicine · 2026Article
- From microscopy to antimicrobial decisions: a clinically grounded roadmap for critical care infectious diseases.Frontiers in artificial intelligence · 2026Review
- Recent advances in early screening and diagnosis of sepsis: a narrative review.Frontiers in cellular and infection microbiology · 2026Review
- Application of metagenomic next-generation sequencing technology in hematologic malignancy patients with sepsis following antibiotic use.BMC infectious diseases · 2025Article
- Lower airway microbiota compositions and diversity among ventilator-associated pneumonia patients across COVID-19 epidemic phases: a retrospective study.Microbiology spectrum · 2025Article
- Reassessing the promise of NGS in sepsis diagnosis: overcoming scalability barriers.Future microbiology · 2025Article
- Tri-layer microbiology for LMIC Hospitals: linking syndromic panels with reflex culture and targeted sequencing for real world care - a narrative review.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesReview
- Stewardship of Molecular Diagnostics in Transplant Viral Infections.Transplant infectious disease : an official journal of the Transplantation SocietyReview
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Authors and funding
35 authors.
Funding
Abstract
backgroundClinical implications of metagenomics next-generation sequencing (mNGS) in sepsis have not been fully evaluated. This study aimed to determine the diagnostic, therapeutic, and prognostic impacts of mNGS in sepsis.
methodsThis multicenter prospective study was conducted at 19 sites in China from 2020 to 2021, and 859 adult patients hospitalized with sepsis were enrolled. The advantages, challenges, knowledge gaps and privacy risks of mNGS were carefully introduced to all participants, and participants chose on their own to either receive conventional microbiological test (CMT) alone (conventional-test-only group, n = 394) or receive mNGS test along with CMT (combined test group, n = 465). For prognostic analysis, the primary endpoint was 28-day mortality. Secondary endpoints included 7-day mortality and average per-day hospital cost. Inverse probability of treatment weighting was used to balance covariates between groups. Concurrent CMT and mNGS results from patients in the combined test group were used for diagnostic analyses. Therapeutic impact of mNGS was evaluated based on subsequent antibiotic adjustment.
resultsCompared with composite reference standard, the positive percent agreement of mNGS among infected site samples was significantly higher than that of CMT (92.0% [95% CI, 88.7 to 94.5] vs. 51.1% [95% CI, 45.9 to 56.2], p < 0.001), while the negative percent agreement of mNGS was inferior to that of CMT (39.6% [95% CI, 29.5 to 50.4] vs. 69.2% [95% CI, 58.7 to 78.5], p < 0.001). The mNGS test identified causal microbes in 344 (74.0%) patients, and concomitant antibiotic changes occurred in 136 patients (29.2%). Death by day 7 occurred in 24 of 465 (5.2%) patients in the combined test group and in 34 of 394 (8.6%) patients in the conventional-test-only group (hazard ratio, 0.44 [95% CI, 0.26 to 0.77], p = 0.004). However, no significant difference in 28-day mortality was observed between two study groups (hazard ratio, 0.82 [0.56 to 1.20], p = 0.300).
conclusionsThe mNGS test of infected site samples exhibited 40% higher pathogen detection rate than CMT in patients with sepsis, which led to improved etiological diagnosis and tailored antibiotic therapy. Additional use of mNGS halved the risk of early death in 7 days, but did not improve 28-day survival in patients with sepsis.
trial registrationchictr.org.cn Identifier: ChiCTR2000031113. Registered 22 March 2020.
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