Evidence map›Paper›PMID 40392601›Full record

ArticleJCI insight2025

Metagenomic detection of central nervous system infections missedby conventional testing.

Noely Evangelista Ferreira, Michael G Berg, Antonio C da Costa, Mary A Rodgers, Esper G Kallas, Cassia G Terrasani Silveira, Mateus Vailant Thomazella, Ana Carolina Soares de Oliveira, Layla Honorato, Heuder Go Paião and 10 more

Abstract read
In one paragraph

Article in JCI insight, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Integrating metagenomics and metatranscriptomics intoThe Journal of general virology · 2026
    Review
  2. Metagenomic next-generation sequencing: new horizons in microbiology.Frontiers in cellular and infection microbiology · 2026
    Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Noely Evangelista FerreiraDepartamento de Infectologia e Medicina Tropical, Faculdade de Medicina, and.
Michael G BergInfectious Diseases Research, Abbott Diagnostics, Abbott Park, Illinois, USA.
Antonio C da CostaDepartamento de Infectologia e Medicina Tropical, Faculdade de Medicina, and.
Mary A RodgersInfectious Diseases Research, Abbott Diagnostics, Abbott Park, Illinois, USA.
Esper G KallasDepartamento de Infectologia e Medicina Tropical, Faculdade de Medicina, and.
Cassia G Terrasani SilveiraDepartamento de Infectologia e Medicina Tropical, Faculdade de Medicina, and.
Mateus Vailant ThomazellaDepartamento de Infectologia e Medicina Tropical, Faculdade de Medicina, and.
Ana Carolina Soares de OliveiraDepartamento de Infectologia e Medicina Tropical, Faculdade de Medicina, and.
Layla HonoratoDepartamento de Infectologia e Medicina Tropical, Faculdade de Medicina, and.
Heuder Go PaiãoDepartamento de Infectologia e Medicina Tropical, Faculdade de Medicina, and.
Renan Barros DominguesSenne Liquor Diagnóstico, São Paulo, Brazil.
Carlos SenneSenne Liquor Diagnóstico, São Paulo, Brazil.
Marina F CôrtesDepartamento de Infectologia e Medicina Tropical, Faculdade de Medicina, and.
Tania R Tozetto-MendozaDepartamento de Infectologia e Medicina Tropical, Faculdade de Medicina, and.
Hélio R GomesDivisão Neurologia - Hospital das Clinicas da Faculdade de Medicina da USP, University of São Paulo, São Paulo, Brazil.
Maria Laura Mariano MatosFaculdade de Medicina, Universidade de São Caetano do Sul, São Paulo, Brazil.
Geovani de Oliveira RibeiroDepartamento de Biologia Celular, Universidade de Brasília (UNB), University of São Paulo, São Paulo, Brazil.
Steven S WitkinDepartamento de Infectologia e Medicina Tropical, Faculdade de Medicina, and.
Gavin A ClohertyInfectious Diseases Research, Abbott Diagnostics, Abbott Park, Illinois, USA.
Maria Cassia Mendes-CorreaDepartamento de Infectologia e Medicina Tropical, Faculdade de Medicina, and.

Funding

Systems investigation of vaccine responses in B cell depleted autoimmune patientsU19AI089992 · NIAID · YALE UNIVERSITY · PI Albert C Shaw · 2010 to 2026
$50.4M
Project 3 - Ex vivo immune profiling of dengue viruses and vaccinesU19AI118610 · NIAID · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI HARRIS, EVA · 2015 to 2021
$46.6M
Systems Biological Analysis of Innate and Adaptive Responses to VaccinationU19AI090023 · NIAID · EMORY UNIVERSITY · PI AHMED, RAFI, LI, SHUZHAO · 2010 to 2021
$45.0M
Understanding Asthma EndotypesU19AI077439 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI PRESCOTT G WOODRUFF · 2008 to 2026
$41.1M
Transcriptomics to define biomarkers of neonatal vaccine immunogenicityU19AI118608 · NIAID · BOSTON CHILDREN'S HOSPITAL · PI LEVY, OFER · 2017 to 2021
$24.7M
Inner City Asthma Consortium: Immunologic Approaches to Reduce AsthmaN01AI25496 · NIAID · UNIVERSITY OF WISCONSIN-MADISON · 2007 to 2008
$23.7M
Research BaseP30DK063720 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GERMAN, MICHAEL S · 2003 to 2019
$21.8M
Tollip inhibits IL-33 signaling during airway influenza virus infectionU19AI125357 · NIAID · UNIVERSITY OF ARIZONA · PI KRAFT, MONICA, VERCELLI, DONATA · 2016 to 2025
$14.7M
Project 3: Mapping the Evolution of Chronic Transplant Injury in the Context of CMV InfectionU19AI128913 · NIAID · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI REED, ELAINE F, SARWAL, MINNIE M · 2017 to 2021
$11.2M
Medical Scientist Training Program (T32 NRSA Training Grant)T32GM141323 · NIGMS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Aimee Kao · 2021 to 2026
$10.5M
The contribution of GPCRs to thymocyte medullary entry and central toleranceR01AI104870 · NIAID · UNIVERSITY OF TEXAS AT AUSTIN · PI Lauren Ilyse Richie EHRLICH · 2014 to 2026
$7.6M
Investigating the impact of helminth infection on microbioma composition and innate immunity generated during HepB vaccination. U19AI128910 · NIAID · DREXEL UNIVERSITY · PI HADDAD, ELIAS K · 2017 to 2021
$7.0M
NIAID NIH HHS N01AI25482NIAID NIH HHS N01AI25496NIAID NIH HHS R01 AI104870NIAID NIH HHS R01 AI135803NIAID NIH HHS R01 AI146581NIAID NIH HHS U19 AI077439NIAID NIH HHS U19 AI089992NIAID NIH HHS U19 AI090023NIAID NIH HHS U19 AI118608NIAID NIH HHS U19 AI118610NIAID NIH HHS U19 AI125357NIAID NIH HHS U19 AI128910NIAID NIH HHS U19 AI128913NIDDK NIH HHS P30 DK063720NIGMS NIH HHS T32 GM141323
6 · The paper itself

Abstract

Community-acquired infectious meningoencephalitis is associated with high rates of mortality and morbidity, compounded by limited access to diagnostic resources. The current study assessed acute central nervous system (CNS) infections in patients with meningoencephalitis enrolled in a hospital-based diagnostic surveillance study in São Paulo, Brazil. Cerebrospinal fluid (CSF) was collected from 600 patients between March 2018 and November 2019 and initially screened for a broad range of pathogens according to a local diagnostic algorithm. Standard microbiological and molecular diagnostic methods were applied. Metagenomic sequencing was used as a complementary approach to investigating etiology in instances where no pathogen was initially identified. Standard testing identified infectious etiologies in 292 patients (48.6%), with 227 (77.7%) confirmed as viral infections, predominantly caused by enteroviruses (n = 144) and herpesviruses (n = 40). Nonviral agents were identified in 65 patients (22.3%). Metagenomic sequencing (mNGS) of 277 of 308 undiagnosed patients revealed several additional potential etiologies, including Parvovirus B19, Toxoplasma gondii, Picobirnavirus, other enterovirus species and Vesivirus, the latter being associated with CNS infection for the first time. These findings underscore the complexity of CNS infections and highlight the potential of metagenomics to improve diagnostic accuracy, inform treatment strategies, and support efforts to address future pandemics.

Indexed as

Central Nervous System InfectionsMeningoencephalitisMetagenomicsAdolescentAdultAgedBrazilChildChild, PreschoolEnterovirusFemaleHumansInfantMaleMiddle AgedToxoplasmaClinical ResearchInfectious diseaseMolecular diagnosis

Identifiers

PMID40392601
PMCPMC12306619

What OpenQuestion holds

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Registered trials

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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.