Evidence map›Paper›PMID 41928273›Full record

ArticleCritical care (London, England)2026

Broad-spectrum targeted next-generation sequencing: is it ready for routine deployment in intensive care units for severe pneumonia?

How-Yang Tseng, Yu-Chang Fu, Yue-Hua Su, Yu-Chu Kuo, Shinn-Jye Liang, Yi-Cheng Shen, Wei-Cheng Chen, Chieh-Lung Chen, Yu-Chao Lin, Meng-Yu Cheng and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care (London, England), 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. 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

14 authors.

How-Yang TsengDivision of Pulmonary and Critical Care, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Yu-Chang FuDivision of Pulmonary and Critical Care, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Yue-Hua SuDivision of Pulmonary and Critical Care, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Yu-Chu KuoDivision of Pulmonary and Critical Care, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Shinn-Jye LiangDivision of Pulmonary and Critical Care, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Yi-Cheng ShenDivision of Pulmonary and Critical Care, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Wei-Cheng ChenDivision of Pulmonary and Critical Care, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Chieh-Lung ChenDivision of Pulmonary and Critical Care, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Yu-Chao LinDivision of Pulmonary and Critical Care, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Meng-Yu ChengDivision of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Chih-Hao ChenDivision of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Chih-Yen TuDivision of Pulmonary and Critical Care, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Zi-Lun LaiDepartments of Laboratory Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Po-Ren HsuehDepartments of Laboratory Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan. hsporen@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Targeted next-generation sequencing (tNGS) has demonstrated higher analytical detection of respiratory pathogens than conventional microbiological tests (CMTs), yet its real-world clinical value in intensive care units (ICUs) remains uncertain. We conducted an interim analysis of a prospective study including 51 adult ICU patients with severe pneumonia at a tertiary medical center in Taiwan and examined the challenges to its routine implementation in the ICU. Bronchoalveolar lavage samples were analyzed using a hybrid capture–based Respiratory Pathogen ID/AMR Enrichment Panel (RPIP) and compared with standard testing (CMT combined with the FilmArray Pneumonia Panel [FAPP]). Causative pathogens were determined through multidisciplinary expert adjudication. RPIP showed a higher analytical detection rate than standard testing (90.2% vs. 82.4%). However, the proportion of adjudicated causative pathogens was similar between RPIP and standard testing (47.1% vs. 49.0%), with no significant difference (McNemar’s exact test, p = 1.00). After expert adjudication, RPIP provided additional clinically actionable yield in 23.5% of patients compared with CMT + FAPP, mainly related to antimicrobial resistance determinants, while 17.6% showed concordant results, 13.7% demonstrated lower yield with RPIP, and 45.1% of cases had no adjudicated causative pathogen after comprehensive review. Although tNGS broadens pathogen and resistance detection, its routine implementation in the ICU requires clearly defined indications, validated genotype–phenotype correlations, optimized turnaround time, strict contamination control, and structured multidisciplinary integration.

Indexed as

High-Throughput Nucleotide SequencingIntensive Care UnitsPneumoniaSeverity of Illness IndexAgedBronchoalveolar Lavage FluidFemaleHumansMaleMiddle AgedProspective StudiesTaiwan

Identifiers

PMID41928273
PMCPMC13047820

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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.