Evidence map›Paper›PMID 41286813›Full record

ArticleBMC pediatrics2025

Clinical application and impact of metagenomic next-generation sequencing for the diagnosis of infectious diseases in severely immunocompromised pediatric patients.

Huili Shen, Xiaolei Zhang, Bingxue Hu, Yixue Wang, Bin Yang, Panpan Fan, Jing Liu, Zhenyu Zhang, Weiming Chen, Liming He and 3 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
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

13 authors.

Huili Shen *Department of Critical Care Medicine, and National Health Commission Key Laboratory of Neonatal Diseases, Shanghai Institute of Infectious Disease and Biosecurity, Children's Hospital of Fudan University, Fudan University, Shanghai, 200032, China.
Xiaolei Zhang *Department of Critical Care Medicine, and National Health Commission Key Laboratory of Neonatal Diseases, Shanghai Institute of Infectious Disease and Biosecurity, Children's Hospital of Fudan University, Fudan University, Shanghai, 200032, China.
Bingxue Hu *Center for Infectious Diseases, Vision Medicals Co., Ltd, Guangzhou, 510000, Guangdong Province, China.
Yixue WangDepartment of Critical Care Medicine, and National Health Commission Key Laboratory of Neonatal Diseases, Shanghai Institute of Infectious Disease and Biosecurity, Children's Hospital of Fudan University, Fudan University, Shanghai, 200032, China.
Bin YangCenter for Infectious Diseases, Vision Medicals Co., Ltd, Guangzhou, 510000, Guangdong Province, China.
Panpan FanDepartment of Critical Care Medicine, and National Health Commission Key Laboratory of Neonatal Diseases, Shanghai Institute of Infectious Disease and Biosecurity, Children's Hospital of Fudan University, Fudan University, Shanghai, 200032, China.
Jing LiuDepartment of Critical Care Medicine, and National Health Commission Key Laboratory of Neonatal Diseases, Shanghai Institute of Infectious Disease and Biosecurity, Children's Hospital of Fudan University, Fudan University, Shanghai, 200032, China.
Zhenyu ZhangDepartment of Critical Care Medicine, and National Health Commission Key Laboratory of Neonatal Diseases, Shanghai Institute of Infectious Disease and Biosecurity, Children's Hospital of Fudan University, Fudan University, Shanghai, 200032, China.
Weiming ChenDepartment of Critical Care Medicine, and National Health Commission Key Laboratory of Neonatal Diseases, Shanghai Institute of Infectious Disease and Biosecurity, Children's Hospital of Fudan University, Fudan University, Shanghai, 200032, China.
Liming HeDepartment of Critical Care Medicine, and National Health Commission Key Laboratory of Neonatal Diseases, Shanghai Institute of Infectious Disease and Biosecurity, Children's Hospital of Fudan University, Fudan University, Shanghai, 200032, China.
Weiguo YangPediatric Intensive Care Unit, Shenzhen Children's Hospital, Guangdong, 518000, China. replicater@163.com.
Guoping LuDepartment of Critical Care Medicine, and National Health Commission Key Laboratory of Neonatal Diseases, Shanghai Institute of Infectious Disease and Biosecurity, Children's Hospital of Fudan University, Fudan University, Shanghai, 200032, China. lgp@fudan.edu.cn.
Gangfeng YanDepartment of Critical Care Medicine, and National Health Commission Key Laboratory of Neonatal Diseases, Shanghai Institute of Infectious Disease and Biosecurity, Children's Hospital of Fudan University, Fudan University, Shanghai, 200032, China. gangfeng_yan@fudan.edu.cn.

Funding

CHFU Young Talents Program EKQM202406Shanghai Committee of Science and Technology 25ZR1401032Shanghai Municipal Health System major supports discipline projects 2023ZDFC0103Shanghai Municipal Science and Technology Major Project ZD2021CY001
6 · The paper itself

Abstract

backgroundAccurate and rapid microbiological diagnosis is essential for the identification and management of critically ill children experiencing immunocompromised (ICH) conditions. Metagenomic next-generation sequencing (mNGS) has shown promising applications in diagnosing infectious diseases in adults; however, its performance in critically ill pediatric infections remains elusive. We aimed to evaluate the performance of mNGS, compared with that of conventional microbiological tests (CMT) as a front-line diagnostic tool for pediatric intensive care unit (PICU) patients, and assess its clinical impact.

methodsIn this retrospectively study, a total of 179 samples including blood, sputum or cerebrospinal fluid etc. from 97 children, categorized as ICH or immunocompetent (ICO), were included. The positive detection rate and diagnostic performance (sensitivity, specificity) of mNGS and CMT were compared. The clinical impact of mNGS was assessed on its influence on diagnosis and treatment decisions.

resultsmNGS demonstrated a significantly higher positive rate than CMT (72.63% vs. 55.31%, P < 0.001), particularly in sputum and cerebrospinal fluid (CSF) samples, among both ICH and ICO samples. Samples from ICH patients exhibited a relatively higher positive rate and yielded more microbes detections than ICO samples with both methods. The sensitivity of mNGS assay was 91.34%, significantly outperforming CMT (73.23%, P < 0.001). The specificity of mNGS was 73.08%, relatively lower than that of CMT (88.46%, P < 0.05). Specific to ICH and ICO, mNGS showed significantly higher sensitivity than CMT (ICH: 94.94% vs. 81.01%, P < 0.01; ICO:85.42% vs. 60.42%, P < 0.01). Regarding clinical impact, mNGS had a positive impact on diagnosis in 66.0% patients, with a significantly higher proportion of positive impacts observed in ICH samples compared to ICO samples (P < 0.05).

conclusionsmNGS exhibited superior diagnostic performance compared to CMT for diagnosing infections in critically ill children. More than half (66.0%) of mNGS tests resulted in a positive clinical impact on diagnosis and treatment, particularly among ICH patients.

Indexed as

Communicable DiseasesHigh-Throughput Nucleotide SequencingImmunocompromised HostMetagenomicsAdolescentChildChild, PreschoolCritical IllnessFemaleHumansInfantIntensive Care Units, PediatricMaleRetrospective StudiesSensitivity and SpecificityDiagnosisImmunocompromisedInfectionIntensive care unitMetagenomic next-generation sequencing (mNGS)Pediatric

Identifiers

PMID41286813
PMCPMC12642207

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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.