mNGS and Sepsis Mortality Reduction

Objectives: To evaluate the utility of metagenomic next-generation sequencing (mNGS) in guiding antibiotic regimen adjustments for septic patients admitted to the intensive care unit (ICU), and to assess its impact on 28-day mortality. Methods: A retrospective study was conducted on 303 patients with sepsis admitted to the ICU between January 2021 and December 2022. Patients were divided into the mNGS group (93 cases) and the non-mNGS group (130 cases). Statistical analysis included linear regression, binary logistic regression, propensity score matching (PSM), and mediation analysis. Results: A 1:1 PSM was performed for the two groups, yielding a matched cohort of 80 patients per group. In the matched cohort, antibiotics adjustments based on pathogenic detection results were more frequent in the mNGS group than in the non-mNGS group (P 0.05). Binary logistic regression further confirmed significant associations of mNGS detection with a higher likelihood of antibiotic adjustment (odds ratio [OR] = 39.082, P