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Background <p>Intraocular infection is a vision-threatening condition requiring rapid and accurate pathogen identification to guide timely antimicrobial therapy. This study evaluated the diagnostic performance of metagenomic next-generation sequencing (mNGS) and its clinical impact on treatment decision-making.</p> Methods <p> A total of 100 patients with suspected intraocular infection were included. Intraocular samples were analyzed using mNGS and conventional microbiological methods. Diagnostic performance was assessed against a composite clinical reference standard. Turnaround time (TAT) and antimicrobial regimen adjustments following mNGS results were evaluated.</p> Results <p> Among 80 clinically confirmed infections, mNGS demonstrated significantly higher sensitivity (97.9% vs. 17.7%) and diagnostic accuracy (96.6% vs. 31.9%) compared with conventional testing. Bacterial pathogens predominated (68.8%), with Staphylococcus epidermidis and Streptococcus pneumoniae being most common. mNGS identified 79 infections missed by conventional methods, including polymicrobial infections (10.0%) and atypical or difficult-to-culture organisms. The median TAT for mNGS was 25 hours, substantially shorter than that of conventional testing (approximately 90 hours). Based on mNGS results, antimicrobial regimens were modified in 36 patients (45.6%), including treatment escalation, de-escalation, or complete regimen changes, leading to improved pathogen-directed therapy.</p> Conclusion <p> mNGS provides rapid and highly sensitive pathogen detection in intraocular infection and has a meaningful impact on antimicrobial decision-making, supporting earlier and more targeted clinical management.</p>

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Metagenomic next-generation sequencing for comprehensive pathogen detection in intraocular infection

  • 期刊论文

  • 发表日期：

    2026年4月9日

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  • Peiting Liu,
  • Jialiang Zhang,
  • Xin Liu,
  • Binghui Li,
  • Yingqian Peng,
  • Bingchu Li,
  • Xing Lyu,
  • Li Tan,
  • Zheng Guo,
  • Ziyang Li,
  • Min Hu

摘要

Background

Intraocular infection is a vision-threatening condition requiring rapid and accurate pathogen identification to guide timely antimicrobial therapy. This study evaluated the diagnostic performance of metagenomic next-generation sequencing (mNGS) and its clinical impact on treatment decision-making.

Methods

A total of 100 patients with suspected intraocular infection were included. Intraocular samples were analyzed using mNGS and conventional microbiological methods. Diagnostic performance was assessed against a composite clinical reference standard. Turnaround time (TAT) and antimicrobial regimen adjustments following mNGS results were evaluated.

Results

Among 80 clinically confirmed infections, mNGS demonstrated significantly higher sensitivity (97.9% vs. 17.7%) and diagnostic accuracy (96.6% vs. 31.9%) compared with conventional testing. Bacterial pathogens predominated (68.8%), with Staphylococcus epidermidis and Streptococcus pneumoniae being most common. mNGS identified 79 infections missed by conventional methods, including polymicrobial infections (10.0%) and atypical or difficult-to-culture organisms. The median TAT for mNGS was 25 hours, substantially shorter than that of conventional testing (approximately 90 hours). Based on mNGS results, antimicrobial regimens were modified in 36 patients (45.6%), including treatment escalation, de-escalation, or complete regimen changes, leading to improved pathogen-directed therapy.

Conclusion

mNGS provides rapid and highly sensitive pathogen detection in intraocular infection and has a meaningful impact on antimicrobial decision-making, supporting earlier and more targeted clinical management.