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How mNGS transforms care for non-verbal elderly stroke patients with pneumonia

Yuhai Dang1

  • 1Department of Respiratory and Critical Care Medicine, Guangxi Jiangbin Hospital, Nanning, Guangxi, China.

Frontiers in Cellular and Infection Microbiology
|July 8, 2026
PubMed
Abstract

Insights

Metagenomic next-generation sequencing (mNGS) improves pathogen detection in stroke-associated pneumonia (SAP) patients, leading to better survival rates and reduced costs compared to conventional methods.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Medical Diagnostics

Background:

  • Stroke-associated pneumonia (SAP) is a critical complication in elderly, non-verbal stroke patients.
  • Conventional microbial culture methods for SAP diagnosis have low sensitivity and slow turnaround times, hindering effective treatment.

Purpose of the Study:

  • To evaluate the efficacy of metagenomic next-generation sequencing (mNGS) compared to conventional culture for diagnosing SAP in non-verbal elderly patients.
  • To assess the impact of mNGS-guided therapy on clinical outcomes and healthcare resource utilization.

Main Methods:

  • A retrospective cohort study involving 64 non-verbal elderly SAP patients (≥65 years).
  • Patients were divided into mNGS (n=30) and conventional culture (n=34) groups, with propensity score matching applied.
  • Clinical outcomes, pathogen detection rates, and treatment adjustments were compared between groups.

Main Results:

  • mNGS detected a higher number of bacterial pathogens and identified viral/atypical pathogens missed by culture.
  • The mNGS group showed significantly improved 28-day and 90-day survival rates.
  • mNGS was associated with reduced invasive mechanical ventilation, shorter antibiotic duration, and lower hospitalization costs.

Conclusions:

  • mNGS offers comprehensive pathogen detection for non-verbal elderly SAP patients, guiding targeted antimicrobial therapy.
  • mNGS is linked to enhanced survival and decreased healthcare resource consumption.
  • Further large-scale, multicenter prospective studies are warranted to validate these findings.
Keywords:
antimicrobial stewardshipelderlymetagenomic next-generation sequencingmortalitynon-verbalpathogen detectionstroke-associated pneumonia

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