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Objective <p>This study aimed to evaluate the impact of pathogen-targeted next-generation sequencing (pt-NGS) technology on antimicrobial use and clinical outcomes in hospitalized adults with lower respiratory tract infections (LRTIs).</p> Methods <p>In this retrospective cohort study, 340 adult LRTI patients were stratified into two groups: a pt-NGS-guided group (<i>n</i> = 140) and a conventional microbiological testing-guided group (<i>n</i> = 200). Outcomes included pathogen detection rates, antimicrobial therapy adjustments, clinical outcomes (mortality, length of stay LOS, ICU admission), and healthcare costs. Statistical analyses utilized t-tests, Mann-Whitney U tests, and multivariable regression.</p> Results <p>The pt-NGS group exhibited significantly higher pathogen detection rates (90.9%vs. 52.5%, <i>P</i> &lt; 0.001) and a greater proportion of antimicrobial regimen adjustments (38.0%vs.16.7%, <i>P</i> = 0.013). Clinically, the pt-NGS group exhibited a shorter median duration of inappropriate antibiotic therapy (3.5vs.6days, <i>P</i> = 0.012), reduced hospital LOS and costs(23vs.38days, <i>P</i> = 0.024)/(CN¥26,548 vs. CN¥31,827, <i>P</i> = 0.026),and lower ICU admission rates (30.1% vs. 49.6%, <i>P</i> = 0.016), Mortality did not differ significantly between groups (4.68% vs. 6.10%, <i>P</i> = 0.382).</p> Conclusion <p>pt-NGS technology enhances diagnostic precision, accelerates targeted antimicrobial therapy, and reduces unnecessary broad-spectrum antibiotic exposure, thereby improving clinical outcomes and resource utilization in LRTI management. Notably, no significant mortality benefit was observed, and broad-spectrum antimicrobial use increased in the pt-NGS group. These findings underscore its potential as a valuable tool supporting of antimicrobial stewardship programs in severe respiratory infections.</p>

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The impact of pt-NGS technology on antimicrobial use and outcomes in patients with lower respiratory tract infections: a hospital-based real-world study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月28日

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  • Ziyi Wang,
  • Wanyi Yin,
  • Yupei Hao,
  • Shuai Liu,
  • Shizhao Yuan,
  • Yanjing Zhang,
  • Jing Wang,
  • Shuying Li,
  • Yan Liu,
  • Jing Yu

摘要

Objective

This study aimed to evaluate the impact of pathogen-targeted next-generation sequencing (pt-NGS) technology on antimicrobial use and clinical outcomes in hospitalized adults with lower respiratory tract infections (LRTIs).

Methods

In this retrospective cohort study, 340 adult LRTI patients were stratified into two groups: a pt-NGS-guided group (n = 140) and a conventional microbiological testing-guided group (n = 200). Outcomes included pathogen detection rates, antimicrobial therapy adjustments, clinical outcomes (mortality, length of stay LOS, ICU admission), and healthcare costs. Statistical analyses utilized t-tests, Mann-Whitney U tests, and multivariable regression.

Results

The pt-NGS group exhibited significantly higher pathogen detection rates (90.9%vs. 52.5%, P < 0.001) and a greater proportion of antimicrobial regimen adjustments (38.0%vs.16.7%, P = 0.013). Clinically, the pt-NGS group exhibited a shorter median duration of inappropriate antibiotic therapy (3.5vs.6days, P = 0.012), reduced hospital LOS and costs(23vs.38days, P = 0.024)/(CN¥26,548 vs. CN¥31,827, P = 0.026),and lower ICU admission rates (30.1% vs. 49.6%, P = 0.016), Mortality did not differ significantly between groups (4.68% vs. 6.10%, P = 0.382).

Conclusion

pt-NGS technology enhances diagnostic precision, accelerates targeted antimicrobial therapy, and reduces unnecessary broad-spectrum antibiotic exposure, thereby improving clinical outcomes and resource utilization in LRTI management. Notably, no significant mortality benefit was observed, and broad-spectrum antimicrobial use increased in the pt-NGS group. These findings underscore its potential as a valuable tool supporting of antimicrobial stewardship programs in severe respiratory infections.