Clinical efficacy of plasma cell-free DNA metagenomic next-generation sequencing in diagnosing bloodstream infections.

Qian-Bin Dai, Lan-Min Lai, Qing Zhu, Lei Yuan

Abstract read

In one paragraph

Article in BMC 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.

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1citing papers in PubMed

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1 · What the graph read from it

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1 citing paper in PubMed.

Complementary Utility of Metagenomic Next-Generation Sequencing and Blood Culture for Bloodstream Infections: Insights into Pathogen-Specific Inflammatory and Coagulation Profiles.Infection and drug resistance · 2026
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4 authors.

Qian-Bin DaiDepartment of Clinical Laboratory, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No.17, Yong Wai Zheng Street, Nanchang, 330006, China.

Lan-Min LaiDepartment of Clinical Laboratory, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No.17, Yong Wai Zheng Street, Nanchang, 330006, China.

Qing ZhuDepartment of Clinical Laboratory, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No.17, Yong Wai Zheng Street, Nanchang, 330006, China.

Lei YuanDepartment of Clinical Laboratory, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No.17, Yong Wai Zheng Street, Nanchang, 330006, China. ndyfy06655@ncu.edu.cn.

Funding

the Natural Science Foundation of Jiangxi Province 20242BAB20430the Science and Technology Plan of Jiangxi Provincial Health Commissio 202510284

6 · The paper itself

Abstract

backgroundOur initial goal was to assess the clinical efficacy of using plasma cell-free DNA (cfDNA) to perform metagenomic next-generation sequencing (mNGS) to detect suspected infections.

methodsWe retrospectively analyzed 425 patients who underwent plasma cfDNA mNGS. Of them, 84 patients had various systemic infections, 69 were ruled out of infectious diseases, and 272 had bloodstream infections. Conventional microbiological tests (CMTs) and plasma cfDNA mNGS were conducted concurrently in clinical practice. The sensitivity and specificity of the two techniques were examined based on the final diagnosis.

resultsThe total positive rate (276/425) for the cfDNA mNGS test indicated the presence of microorganisms. The mean length of stay in the hospital for mNGS-positive patients was longer than for mNGS-negative patients (P = 0.0079). Compared with patients with negative mNGS tests, those with positive mNGS tests have significantly lower white blood cell counts in peripheral blood (P = 0.0085). Among all the disorders in our patients, bloodstream infection (272/425, 64.0%) accounted for the most significant percentage. The diagnostic sensitivity of mNGS is also higher than that of CMTs (72.8% vs. 32.9%). However, its diagnostic specificity is lower than CMT’s (75.4% vs. 85.5%). Bacteria were the most frequently identified potential pathogens by mNGS. Klebsiella pneumoniae (n = 46) was the most common pathogen. Candida albicans is the most common fungal infection (n = 18). Human cytomegalovirus (n = 45) is the most common viral infection. The detection rate of mNGS in empirically treated groups was significantly higher than in non-empirically treated groups(71.9% vs. 51.4%, p < 0.0001), which is contrary to conventional microbiological tests(21.7% vs. 41.0%, p < 0.0001). Of the 276 patients with positive mNGS results, clinical management was positively affected in 122 (44.2%) cases. Negative mNGS results led to a modified clinical management regimen in 121 patients. The average hospitalized days for the day 1–3 sampling time were significantly shorter than for the other two groups(sampling time 4–7 days and sampling time ≥ 8 days).

conclusionsOur research found that mNGS has higher positive predictive values (PPVs) than CMTs. Plasma cfDNA mNGS can be used in addition to CMTs to help doctors provide effective anti-infection treatment and reduce hospital stays.

Indexed as

Cell-Free Nucleic AcidsMetagenomicsSepsisAdultAgedBacteremiaBacteriaFemaleHigh-Throughput Nucleotide SequencingHumansMaleMiddle AgedRetrospective StudiesSensitivity and SpecificityCell-Free Nucleic AcidsBloodstream infectionConventional microbiological testDiagnosisMetagenomic next-generation sequencingPlasma cell-free DNA

Identifiers

PMID41864933

DOI10.1186/s12879-026-13134-8

PMCPMC13141588

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LicenceCC BY-NC-ND

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