Diagnostic microbiology and infectious disease最新文献

{"title":"Construction of a superspectrum for rapid identification of opportunistic human pathogens belonging to the genus Phytobacter using whole-cell MALDI-TOF MS","authors":"Alana Mazzetti ,&nbsp;Helena R.S. D’Espindula ,&nbsp;Debora O. Kulek ,&nbsp;Karen L. Jones ,&nbsp;Leticia Kraft ,&nbsp;Theo H.M. Smits ,&nbsp;Fabio Rezzonico ,&nbsp;Marcelo T. Mira ,&nbsp;Marcelo Pillonetto","doi":"10.1016/j.diagmicrobio.2026.117275","DOIUrl":"10.1016/j.diagmicrobio.2026.117275","url":null,"abstract":"<div><h3>Background</h3><div>Members of the genus <em>Phytobacter</em>, part of the <em>Enterobacteriaceae</em>, represent an emerging clinical threat. Standard identification methodologies often fail to accurately identify members of this genus because they are absent from current clinical databases. Molecular techniques are thus pivotal for differentiating <em>Phytobacter</em> from similar genera such as <em>Pantoea, Kluyvera</em>, and <em>Kosakonia</em>. Matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) provides a rapid, reliable, and cost-effective method for identification.</div></div><div><h3>Methods</h3><div>A <em>Phytobacter</em>-specific SuperSpectrum was constructed from 18 well-characterized isolates using standardized culture conditions, protein extraction, and triplicate MALDI-TOF MS acquisition. Only conserved, high-quality peaks were retained in the final model. Its performance was evaluated using 282 retrospective isolates and 23 prospective <em>Phytobacter</em>-suspect isolates. All <em>Phytobacte</em>r identifications, along with 154 non-<em>Phytobacter</em> identifications, were benchmarked against API 20E biochemical testing, VITEK-2 automated identification, MALDI-TOF MS current database for <em>in vitro</em> diagnostic analysis, 16S rRNA gene sequencing, and whole-genome sequencing (WGS).</div></div><div><h3>Results</h3><div>Spectral clustering showed consistent separation of <em>Phytobacter</em> at the genus level. Integration of the new SuperSpectrum into the MALDI-TOF MS SARAMIS database enabled accurate identification, leading to the identification of two retrospective <em>Phytobacter</em> out of 282 <em>Enterobacterales</em> isolates. Finally, prospective testing of 23 contemporary isolates suspected to belong to <em>Phytobacter</em> confirmed their identification against the new reference spectra, achieving 100% concordance with WGS identification, demonstrating the reliability of the updated database for genus-level identification.</div></div><div><h3>Conclusion</h3><div><em>Phytobacter</em> identification by MALDI-TOF MS provides a rapid alternative method for molecular identification of this emerging pathogen.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"115 1","pages":"Article 117275"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful treatment with oseltamivir of an atypical influenza B-associated encephalitis identified by mNGS: A case report","authors":"Bolin Tang ,&nbsp;Ling Lin ,&nbsp;Wushuang Li ,&nbsp;Zhen Li ,&nbsp;Jiangman Zhao ,&nbsp;Wenjing Zhao ,&nbsp;Chaoyang Zhao","doi":"10.1016/j.diagmicrobio.2026.117286","DOIUrl":"10.1016/j.diagmicrobio.2026.117286","url":null,"abstract":"<div><div>This case report describes a 51-year-old female with influenza B-associated encephalitis (IBAE) presenting primarily with insomnia, headache, and dizziness, but without fever, following an initial cough. Routine microbiological tests (cultures, staining, multiplex PCR) on cerebrospinal fluid (CSF) and initial brain/chest CT scans were negative. Diagnosis was confirmed by metagenomic next-generation sequencing (mNGS) detecting influenza B virus in the CSF. Treatment involved oral oseltamivir and fluid replacement for headache/intracranial pressure. Symptoms significantly improved after eight days of oseltamivir, leading to discharge. This case highlights sleep disturbances and headache as primary IBAE symptoms without fever. Routine CSF testing often fails to detect influenza B; early mNGS enables definitive diagnosis, allowing precise, timely treatment (like oseltamivir) and avoiding ineffective empiric therapy or disease worsening.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"115 1","pages":"Article 117286"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing school term and holiday seasonal respiratory virus detection rates in hospitalised children, 2019–2024","authors":"Keita Wagatsuma ,&nbsp;Paul W Bird ,&nbsp;Reiko Saito ,&nbsp;Julian W Tang","doi":"10.1016/j.diagmicrobio.2026.117295","DOIUrl":"10.1016/j.diagmicrobio.2026.117295","url":null,"abstract":"<div><div>We analysed laboratory-confirmed seasonal respiratory virus infections among hospitalised children in Leicester, UK (2019–2024), comparing nucleic acid amplification test (NAAT)-positive/negative test counts and test positivity between school term and holiday periods. Analyses were stratified by age group (pre-school, &lt;5 years; primary school, 5-11 years; comprehensive school, 12-18 years) and by pre-, during-, and post-COVID-19 phases. Across multiple viruses, hospital-based detection and test positivity were generally lower during school holidays than during terms, with the clearest differences observed in children aged &lt;5 years. These findings indicate that the school calendar is associated with hospital-based paediatric respiratory virus detection patterns.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"115 1","pages":"Article 117295"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parasitological and molecular identification and subtype-specific clinical correlates of Blastocystis sp. in HIV-positive patients: Diagnostic and epidemiological insights from Northwest Iran","authors":"Morteza Gholinejad ,&nbsp;Rasool Jafari ,&nbsp;Arash Aminpour","doi":"10.1016/j.diagmicrobio.2026.117266","DOIUrl":"10.1016/j.diagmicrobio.2026.117266","url":null,"abstract":"<div><h3>Objectives</h3><div><em>Blastocystis sp</em>. is a commonly detected intestinal protozoan in immunocompromised individuals, including people living with HIV, yet its clinical relevance remains uncertain. This study aimed to determine the prevalence, molecular subtypes, and clinical associations of <em>Blastocystis sp</em>. infection among HIV-positive patients in Northwest Iran.</div></div><div><h3>Methods</h3><div>In a cross-sectional study, stool samples from 70 HIV-positive patients referred to the Urmia Central Health Centre (2022–2023) were examined using direct microscopy, formalin–ether concentration, and culture. Molecular detection and subtyping were performed via PCR amplification and sequencing of the small subunit ribosomal RNA (SSU rRNA) gene. Associations between infection, gastrointestinal symptoms, and CD4⁺ T-cell counts were statistically analysed.</div></div><div><h3>Results</h3><div><em>Blastocystis sp</em>. was identified in 25 (35.7%) of the 70 patients by microscopy and culture. PCR amplification succeeded in 23 (92%) of these 25 isolates. Sequencing revealed three subtypes: ST3 (52.2%), ST2 (30.4%), and ST1 (17.4%). Infection was significantly associated with gastrointestinal manifestations (p &lt; 0.001). Mean CD4⁺ T-cell counts were markedly lower in Blastocystis-positive patients than in uninfected individuals, with the lowest values observed in those infected with ST1 (187.3 ± 156.2 cells/µL).</div></div><div><h3>Conclusions</h3><div>This study demonstrates a considerable prevalence of <em>Blastocystis sp</em>. among HIV-positive patients in Northwest Iran and a significant association between infection and gastrointestinal symptoms. Reduced CD4⁺ counts may increase susceptibility to Blastocystis infection. Routine laboratory detection of <em>Blastocystis sp</em>. in HIV-infected populations may improve understanding of its clinical relevance in immunocompromised patients.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"115 1","pages":"Article 117266"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Over-testing Galactomannan in patients with hematological malignancies: A retrospective analysis from a tertiary care university hospital in Türkiye","authors":"Ilkay Bozkurt","doi":"10.1016/j.diagmicrobio.2026.117284","DOIUrl":"10.1016/j.diagmicrobio.2026.117284","url":null,"abstract":"<div><div>This study aimed to evaluate the Galactomannan (GM) correlation with radiologic findings, treatment decisions and financial impact of over-testing. In this cohort, GM testing yielded a low diagnostic return, requiring 53 tests to obtain one positive result and 103 tests to identify a probable invasive aspergillosis (IA) case, generating a considerable avoidable financial burden. These findings highlight the need to rationalize GM utilization and align testing with IA risk to reduce hospital costs.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"115 1","pages":"Article 117284"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discovery of parasite proteins in the urine of vivax malaria patients through mass spectrometry","authors":"Himani Tripathi ,&nbsp;Prajna Parimita Kar ,&nbsp;Araveti Prasanna Babu ,&nbsp;Anand Srivastava ,&nbsp;Geeta Pachori ,&nbsp;Tarun Kumar Bhatt","doi":"10.1016/j.diagmicrobio.2026.117281","DOIUrl":"10.1016/j.diagmicrobio.2026.117281","url":null,"abstract":"<div><div>Malaria is an infectious disease that severely affects people worldwide. The detection of its causative organism, <em>Plasmodium</em>, is mainly based on microscopy, polymerase chain reaction, and rapid diagnostic tests, all relying on blood samples. Obtaining blood samples causes pain, poses a risk of infections, and leads to poor compliance in cases of repeated sampling. This highlights the need for non-invasive diagnostic alternatives. Several studies have explored the potential use of non-blood samples, such as saliva, urine, stool, and skin to detect <em>Plasmodium</em>. Urine accumulates changes from the body and thus is an appropriate source for biomarker discovery. A biomarker is a measurable change in the body that is associated with a disease or condition. In this study, the urine samples of <em>Plasmodium vivax</em> infected patients were analyzed through mass spectrometry. A comparison of the infected and control samples revealed several proteins present in one group but absent in the other, with some proteins showing altered levels. A total of 252 human proteins were found in the infected samples only. Gene ontology analysis and functional annotation revealed that these proteins are involved in key biological pathways and processes in both the human host and the parasite, and their presence in urine samples could aid in a deeper understanding of malaria biology. Twenty-eight <em>P. vivax</em> proteins were found in the mass spectrometric analysis of urine samples, including rifin-like protein, single-stranded DNA-binding protein, and profilin. These might serve as potential biomarkers for the non-invasive detection of <em>Plasmodium</em> infection.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"115 1","pages":"Article 117281"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strongyloides stercoralis in type 2 diabetes mellitus: discordant stool and serologic findings in an endemic Brazilian population","authors":"Jefferson Elias-Oliveira ,&nbsp;Émelin Alves dos Santos ,&nbsp;Laura Vilela Souza ,&nbsp;Bruna Campos da Silva ,&nbsp;Márcia Carolina Mazzaro ,&nbsp;Joao Batista Alves de Souza ,&nbsp;Ivanildes Solange da Costa Barcelos ,&nbsp;Rosângela Maria Rodrigues","doi":"10.1016/j.diagmicrobio.2026.117269","DOIUrl":"10.1016/j.diagmicrobio.2026.117269","url":null,"abstract":"<div><div><em>Strongyloides stercoralis</em> is a neglected soil-transmitted helminth capable of causing hyperinfection and disseminated disease in immunocompromised hosts. Type 2 diabetes mellitus (T2D) is associated with immune dysfunction and may increase susceptibility to strongyloidiasis, although data in diabetic populations remain limited. In endemic areas, discrepancies between stool-based and serologic tests may impair accurate diagnosis. We conducted a cross-sectional study in an endemic area of Central Brazil including 80 adults with T2D and 80 non-diabetic controls. Three stool samples per participant were examined by spontaneous sedimentation (Lutz), Rugai, and agar plate culture. Serum IgG anti-Strongyloides antibodies were detected by ELISA using an alkaline extract of Strongyloides venezuelensis larvae, and ELISA-reactive samples were confirmed by immunoblotting. Intestinal parasites or commensal protozoa were identified in 37.5 % of T2D patients and 32.5 % of controls, with no significant difference. Stool positivity for S. stercoralis was low in both groups (1.2 % in T2D vs 7.5 % in controls). Conversely, IgG ELISA seropositivity was significantly higher among T2D patients (31.2 %) than in controls (16.2 %; p = 0.0122). Among ELISA-reactive samples, immunoblot confirmation was obtained in 60 % of T2D patients and 69 % of controls. These results reveal a clear discordance between parasitologic and serologic findings, particularly in T2D patients, who exhibited increased serologic evidence of <em>S. stercoralis</em> infection despite minimal stool-based detection. In this endemic setting, the combination of ELISA followed by immunoblotting emerges as a valuable complementary strategy for diagnosing strongyloidiasis, especially in individuals with T2D who may present altered immune responses and lower sensitivity to stool-based methods.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"114 4","pages":"Article 117269"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High throughput HPV genotyping by next generation sequencing for detection of 28 HPV types and 13 sexually transmitted infections: A first community-based cervical cancer screening study from India","authors":"Yasasve Madhavan,&nbsp;Vasanthkumar Muthukumar,&nbsp;Srinidhi Ramasubramanian,&nbsp;Vijayalakshmi Ramshankar","doi":"10.1016/j.diagmicrobio.2026.117278","DOIUrl":"10.1016/j.diagmicrobio.2026.117278","url":null,"abstract":"<div><h3>Background</h3><div>High-risk human papillomavirus (HR-HPV) infection is the primary cause of cervical cancer. However, conventional PCR-based assays provide limited HPV genotyping, and cytology alone has low sensitivity for detecting subclinical infections. Comprehensive molecular approaches are needed to better characterize HPV genotypes and co-infections in community screening settings.</div></div><div><h3>Methods</h3><div>This study evaluated the analytical performance of a next-generation sequencing (NGS)–based HPV–STI assay in comparison with the clinically validated Roche Cobas^Ⓡ 4800 platform in a community screening cohort from South India. Cervical exfoliated cell samples from 96 asymptomatic, married women previously tested by Cobas^Ⓡ 4800 with partial HR-HPV genotyping (HPV16, HPV18, and a pooled group of 12 other high-risk types) were analyzed using NGS. The NGS assay enabled comprehensive detection of 28 HPV genotypes and 13 sexually transmitted infections (STIs) on the Illumina NextSeq 550 platform. Liquid-based cytology with RAPID-Pap staining was performed for all sequenced samples.</div></div><div><h3>Results</h3><div>The NGS assay showed high agreement with the Cobas^Ⓡ 4800 platform, with an overall concordance of 95.8% (92/96). Concordance was 94.4% (17/18) for HPV16 detection, 100% (3/3) for HPV18, 96.7% (58/60) for pooled other high-risk HPV types (non-HPV16/18), and 85.7% (7/8) for mixed infections, including co-infections of HPV16 or HPV18 with non-HPV16/18 high-risk types as well as HPV16/18 dual infections. Among women with abnormal cytology (ASCUS and HSIL), non-HPV16/18 infections were identified in 58.3% (7/12) of cases. Concurrent non-HPV STIs were detected in 52.1% (50/96) of participants, with <em>Ureaplasma parvum</em> and <em>Mycoplasma hominis</em> being the most prevalent.</div></div><div><h3>Conclusion</h3><div>A substantial proportion of women with abnormal cytology in this community cohort harboured non-HPV16 and HPV18 high-risk infections, highlighting the importance of extended HPV genotyping. NGS-based HPV genotyping was concordant with the comparator assay used and had simultaneous STI identification, supporting its potential utility as a comprehensive tool for community-based cervical cancer screening and risk stratification.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"114 4","pages":"Article 117278"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design, validation and evaluation of a triplex real time qualitative PCR assay targeting zoonotic Capnocytophaga species in EDTA whole blood and plasma simulated clinical specimens","authors":"A.M. Szewc ,&nbsp;A.C. Nicholson ,&nbsp;K. Livingston,&nbsp;C. Hopper,&nbsp;J.R. McQuiston","doi":"10.1016/j.diagmicrobio.2026.117268","DOIUrl":"10.1016/j.diagmicrobio.2026.117268","url":null,"abstract":"<div><div>Found in the oral microbiome of cats and dogs, bacteria from the genus <em>Capnocytophaga</em> occasionally infect humans and can cause serious disease or death if not identified and treated promptly. Described here is a real-time triplex qualitative PCR assay designed using gene targets (<em>rpl</em>V and secY) identified as diagnostically relevant by analysis of genomes from the <em>Capnocytophaga</em> species. The assay was evaluated on simulated EDTA whole blood samples/plasma and is effective at detecting down to 10 copies per microliter (10000 copies per mL, 4 log/mL) for whole blood samples (<em>rpl</em>V /<em>sec</em>Y), and 1 copy per microliter (1000 copies per mL, 3 log mL) (<em>rpl</em>V) and 0.5 copy per microliter (500 copies per mL, 2.69 log mL) (<em>sec</em>Y) for plasma samples. Analytical sensitivity, specificity, and reproducibility were established in plasmid-spiked simulated EDTA whole blood and plasma specimens, and clinical performance in <em>Capnocytophaga</em>-positive patient samples remains to be determined.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"114 4","pages":"Article 117268"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metagenomic next-generation sequencing in pediatric infectious disease diagnosis: A comprehensive systematic literature review and meta-analysis","authors":"Maria Celidonio Gutfreund ,&nbsp;Gustavo Yano Callado ,&nbsp;Isabele Pardo ,&nbsp;Mariana Kim Hsieh ,&nbsp;Patrícia Deffune Celeghini ,&nbsp;Gabriel O.V. Lopes ,&nbsp;Pedro S. Marra ,&nbsp;Yan Runa Cheng ,&nbsp;Takaaki Kobayashi ,&nbsp;João Renato Rebello Pinho ,&nbsp;José Roberto Generoso Jr ,&nbsp;Lucas Bulgarelli ,&nbsp;Eneida A Mendonça ,&nbsp;Rodrigo Octávio Deliberato ,&nbsp;Deyvid Emanuel Amgarten ,&nbsp;Fernanda de Mello Malta ,&nbsp;Michael B Edmond ,&nbsp;Alexandre R. Marra","doi":"10.1016/j.diagmicrobio.2025.117248","DOIUrl":"10.1016/j.diagmicrobio.2025.117248","url":null,"abstract":"<div><h3>Background</h3><div>Diagnosing pediatric infectious diseases is challenging due to nonspecific presentations, small sample volumes, and the limited sensitivity of conventional microbiological tests (CMTs). Metagenomic next-generation sequencing (mNGS) enables broad, hypothesis-free pathogen detection, but its diagnostic performance in children remains insufficiently characterized. This study evaluates the diagnostic accuracy of mNGS in pediatric infectious diseases and compares its performance with CMTs.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis was registered in PROSPERO (CRD42024542444). Searches were performed using multiple databases through August 2024. Eligible studies evaluated mNGS and CMTs in pediatric patients (≤21 years) with suspected infectious diseases and compared their respective results with clinical diagnosis. Pooled sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated using a bivariate random-effects model.</div></div><div><h3>Results</h3><div>Thirty-three studies (n = 4,165) met inclusion criteria, and nine were eligible for meta-analysis. Pooled sensitivity and specificity of mNGS versus clinical diagnosis were 0.84 (95% CI: 0.82–0.86) and 0.71 (95% CI: 0.66–0.75), respectively, compared with 0.40 (95% CI: 0.37–0.43) and 0.82 (95% CI: 0.78–0.86) for CMTs. The pooled DOR favored mNGS (18.6 vs. 5.4). Respiratory infections were most frequently investigated, followed by bloodstream and mixed infections. Over two-thirds of studies reported changes in antimicrobial management following mNGS results.</div></div><div><h3>Conclusions</h3><div>mNGS demonstrates superior sensitivity and diagnostic accuracy compared with CMTs, enabling comprehensive pathogen detection, including rare and co-infecting organisms, and informing targeted antimicrobial therapy. Despite limitations related to cost, complex interpretation, and methodological standardization, mNGS represents a promising complement to conventional diagnostics in pediatric infectious disease management.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"114 4","pages":"Article 117248"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}