Evidence map›Paper›PMID 41743993›Full record

ArticleOpen forum infectious diseases2026

Cerebrospinal Fluid Metagenomic Next-Generation Sequencing in Pediatric Central Nervous System Infection: Clinical Experience and Diagnostic Stewardship Strategies.

Guyu Li, Emily Puumala, Ziyuan Zhang, Nipunie S Rajapakse, Elizabeth H Ristagno, Matthew J Wolf, Amanda A Rodning, Patricia J Simner, James T Gaensbauer, Robin Patel

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Open forum infectious diseases, 2026. 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. Mindful diagnostics: a central nervous system infection case study.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026
    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

10 authors.

Guyu LiDivision of Pediatric Infectious Diseases, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0002-0729-8933
Emily PuumalaDivision of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0009-0008-3371-5877
Ziyuan ZhangSchool of Public Health, University of California, Berkeley, Berkeley, California, USA.ORCID https://orcid.org/0000-0003-3488-5903
Nipunie S RajapakseDivision of Pediatric Infectious Diseases, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0001-9286-2473
Elizabeth H RistagnoDivision of Pediatric Infectious Diseases, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0002-5908-0231
Matthew J WolfDivision of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
Amanda A RodningDivision of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
Patricia J SimnerDivision of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0001-6134-151X
James T GaensbauerDivision of Pediatric Infectious Diseases, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0002-0732-4150
Robin PatelDivision of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0001-6344-4141

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Identification of the microorganisms causing infection in children with central nervous system infection is important. Conventional cerebrospinal fluid (CSF) tests may provide limited pathogen detection. CSF metagenomic next-generation sequencing (mNGS) may provide broader pathogen detection in a single assay. Methods: Results of CSF mNGS testing performed at Mayo Clinic on patients and nonpatients between January 2024 and June 2025 were retrospectively analyzed. The subcohort of children treated at Mayo Clinic was analyzed to assess test performance as compared with conventional CSF diagnostics and potential clinical impact. Results: In total 134 patients (138 CSF mNGS tests) from 22 US states and 2 international sites were included. Overall positivity was 16% with viruses representing most (59%) detections. In the Mayo Clinic subcohort (n = 15), test positivity was 27%: organisms included single detections of Conclusions: CSF mNGS demonstrated higher diagnostic yield in patients whose specimens showed CSF pleocytosis and in those who had PID consultation. Diagnostic stewardship strategies were applied, including specimen hold approaches and PID consultation.

Indexed as

central nervous system infectionscerebrospinal fluidmetagenomicsnext-generation sequencingpediatrics

Identifiers

PMID41743993
PMCPMC12930188

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.