The Real-World Clinical Impact of Plasma mNGS Testing: an Observational Study
Dongsheng Han, Fei Yu, Dan Zhang, Qing Yang, Mengxiao Xie, Lingjun Yuan, Jieyuan Zheng, Jingchao Wang, Jieting Zhou, Yanyan Xiao, Shufa Zheng, Yu Chen
Abstract
In this study, we show that although plasma mNGS testing significantly improved the detection rate of tested samples, nearly one in four (24.5%, 48/196) mNGS tests reported organisms were not clinically relevant, emphasizing the importance of cautious interpretation and infectious disease consultation. Moreover, based on clinical adjudication, plasma mNGS testing resulted in no or a negative impact in nearly half (43.5%, 64/147) of patients in the current study, indicating that how best to integrate this advanced method into current infectious disease diagnostic frameworks to maximize its clinical utility in real-world practice is an important question. Therefore, recommending plasma mNGS testing as a routine supplement to first-line diagnostic tests for infectious diseases faces great challenges. The decision to conduct mNGS testing should take into account the diagnostic performance, turnaround time and cost-effectiveness of mNGS, as well as the availability of conventional tests.