Next-generation sequencing for cytomegalovirus genotypic antiviral resistance testing

Sanger-based sequencing has long served as the gold standard for detecting cytomegalovirus (CMV) resistance mutations. However, next-generation sequencing (NGS) offers a highly multiplexed and sensitive approach. Clinical implementation of NGS-antiviral resistance testing requires thorough validation. In this issue of the Journal of Clinical Microbiology, M. A. Mallory, W. C. Hymas, K. E. Simmon, M. T. Pyne, et al. (J Clin Microbiol 61:e00829-23, 2023, https://doi.org/10.1128/jcm.00829-23) detail a validation of a targeted NGS-based assay for multiple genomic regions that confer resistance to CMV antivirals and share their bioinformatics analysis and reporting pipeline. This validation can serve as guidance for laboratories wishing to develop similar methodologies.