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Updated: Aug 5, 2026

Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid for the Detection of Central Nervous System Pathogens
10:08

Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid for the Detection of Central Nervous System Pathogens

Published on: April 17, 2026

Clinical utility of metagenomic next-generation sequencing in infants with severe infections

Yuanyuan Gao1, Yuhan Huang2, Wenmei Li2

  • 1Department of Clinical Laboratory, Children's Hospital of Soochow University, Suzhou, Jiangsu, China.

Frontiers in Microbiology
|July 31, 2026
PubMed
Abstract

Insights

Metagenomic next-generation sequencing (mNGS) detects more pathogens than conventional culture in critically ill infants. Mean corpuscular hemoglobin, cholinesterase, and procalcitonin predict mNGS results, improving diagnostic accuracy.

Area of Science:

  • Medical Diagnostics
  • Genomics
  • Pediatric Infectious Diseases

Background:

  • Severe infections in critically ill infants pose diagnostic challenges.
  • Conventional microbiological culture has limitations in pathogen detection.

Purpose of the Study:

  • Compare pathogen detection rates of metagenomic next-generation sequencing (mNGS) versus conventional culture in critically ill infants.
  • Identify clinical laboratory parameters associated with mNGS positivity.

Main Methods:

  • Retrospective study of 105 infants with severe infections undergoing both mNGS and conventional culture.
  • LASSO and multivariable logistic regression identified predictors of mNGS positivity.
  • Receiver operating characteristic (ROC) curve analysis evaluated predictive performance.

Main Results:

  • mNGS showed significantly higher positivity rates than conventional culture across most specimen types (p < 0.05).
  • Mean corpuscular hemoglobin (MCH), cholinesterase, and procalcitonin (PCT) were independently associated with mNGS positivity.
  • A combined model of MCH, cholinesterase, and PCT achieved an AUC of 0.842, with 87.2% sensitivity and 81.6% specificity.

Conclusions:

  • mNGS offers superior pathogen detection compared to conventional culture in critically ill infants.
  • MCH, cholinesterase, and PCT are valuable biomarkers for predicting mNGS positivity.
  • A multi-marker model significantly enhances the prediction of mNGS-positive cases, aiding clinical decision-making.
Keywords:
clinical characteristicsinfantsmetagenomic next-generation sequencingpathogenic microorganismssevere infection

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