A real-world study has found that a new metagenomic next-generation sequencing (mNGS) test can detect neurological infections better than standard clinical techniques.

Researchers at the University of California, San Francisco (UCSF) in the US created the test to identify ‘mysterious’ inflammatory neurological conditions.

The test is designed to detect nearly all bacteria, viruses, fungi and parasites from a spinal fluid sample.

For the study, the team only enrolled patients who were hospitalised due to an acute neurological condition but did not receive a conclusive diagnosis. It involved 204 paediatric and adult subjects with meningitis, encephalitis or myelitis.

The mNGS test was able to identify many of the same infections detected by standard laboratory methods, along with 13 infections that were missed by all traditional tests, noted the researchers.

Furthermore, the new test was able to help in treatment decisions for more than 50% of these cases.

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UCSF laboratory medicine and medicine professor Charles Chiu said: “The mNGS test is generally ordered as a test of last resort, and we ended up enrolling the hardest patients to diagnose.

“All conventional microbiology tests combined yield diagnoses in less than 50% of these patients. We’ve shown that a single test – mNGS – can make a significant dent in that number.”

Overall, the mNGS test diagnosed 32 nervous system infections in 31 patients, including 13 diagnoses made by the test alone and confirmation of 19 infections identified by conventional tests as well.

However, the test failed to detect 26 infections. Researchers said that in most of these cases, the pathogen DNA was absent in the spinal fluid, thereby needing a different sample.

Findings from the study have been published in the New England Journal of Medicine.