ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1710412
This article is part of the Research TopicExploring Clinical Application Scenarios of Metagenomic Next-Generation Sequencing for Pathogen DiagnosisView all 11 articles
Cost-Effectiveness Analysis of Metagenomic Next-Generation Sequencing versus traditional bacterial cultures for Postoperative Central Nervous System Infections in Critical Care settings: A Prospective Pilot Study
Provisionally accepted
- 1Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- 2School of Information Science and Technology, Beijing University of Technology, Beijing, China
- 3Stanley and Karen Pigman College of Engineering, University of Kentucky, Lexington, Kentucky, United States
- 4Department of Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- 5Beijing Shijitan Hospital Capital Medical University, Beijing, China
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Background: Early and accurate pathogen identification is crucial for managing central nervous system infections (CNSIs). While Metagenomic Next-Generation Sequencing (mNGS) offers rapid and sensitive pathogen detection, its cost-effectiveness in postoperative neurosurgical patients in critical care settings remains underexplored. Our study aims to investigate the clinical health economic value of mNGS in detecting pathogens of CNSIs after neurosurgery. Methods: In this prospective pilot study, 60 patients with CNSIs at Beijing Tiantan Hospital ICU (March 2023-January 2024) were randomized 1:1 to mNGS or conventional pathogen culture groups. A decision-tree model compared cost-effectiveness using incremental cost-effectiveness ratios (ICERs). A decision-tree model was used to compare the cost-effectiveness between mNGS and traditional pathogen culture methods using incremental cost-effectiveness ratios (ICERs). Results: From March 2023 to January 2024, 60 patients were included. mNGS demonstrated superior diagnostic efficiency with shorter turnaround time (1 vs 5 days; _P_<0.001) and lower anti-infective costs (¥18,000 vs ¥23,000; _P_=0.02). Despite higher detection costs (¥4,000 vs ¥2,000; _P_<0.001), the ICER of ¥36,700 per additional timely diagnosis suggested cost-effectiveness at China's GDP-based WTP threshold. No significant differences in hospitalization duration or total costs were observed (_P_>0.05). Conclusion: mNGS improves diagnostic efficiency and reduces antimicrobial expenditure for postoperative CNSIs in critical care, demonstrating favorable cost-effectiveness when considering clinical outcome gains.
Keywords: central nervous system infections (CNSIs), metagenomic next-generation sequencing(mNGS), Pathogen culture, cost-effectiveness analysis, incremental cost-effectiveness ratio(ICER)
Received: 22 Sep 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Tian, Xu, Chen, Xu, Zhou and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Linlin Zhang, abluelemon@163.com
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