ICCMg 2024 in Geneva: The Power of mNGS for Infectious Disease Diagnosis
ICCMg 2024 brought together clinical microbiologists and infectious disease specialists in Geneva, Switzerland in November 2024. Micronbrane Medical was represented by Dr. Amos Adler, director of clinical microbiology at a major medical center in Tel Aviv, Israel, who presented clinical validation data for metagenomic next-generation sequencing (mNGS) in sterile body fluids using the PaRTI-Seq™ workflow.
About This Presentation
Dr. Adler’s research focused on challenging sample types where traditional diagnostics frequently fail: cerebrospinal fluid (CSF), synovial fluid, and vitreous humor — collectively called sterile body fluids. These specimens are drawn once, in small volumes, from patients with serious or sight-threatening infections. Culture and PCR miss a substantial proportion of cases; Dr. Adler’s team set out to quantify that gap and demonstrate where mNGS closes it.
The PaRTI-Seq workflow evaluated in this study paired the Devin™ Microbial Enrichment Kit with the Unison Ultralow DNA NGS Library Prep Kit and the PaRTI-Seq Analysis bioinformatics pipeline. Head-to-head comparisons were performed against conventional culture and PCR reference standards across 40 positive samples and 11 true-negative controls.
The conference poster is available for download: Tel Aviv Sourasky Medical Center — ICCMg 2024 Poster (PDF)
Key Highlights from the ICCMg 2024 Talk
- 92.1% overall sensitivity, 100% specificity across 40 culture- or PCR-confirmed positive samples; the three false-negative cases were all Staphylococcus aureus from samples with suspected DNA degradation — not a platform limitation
- Endophthalmitis and uveitis emerged as a high-value clinical niche: vitreous taps yield tiny sample volumes, the differential spans bacterial, fungal, viral (HSV, VZV, CMV), and parasitic causes, and there is usually only one sample collection opportunity — exactly the scenario where unbiased mNGS provides the most clinical leverage
- RPM ratio threshold of 10 (RPMR = reads per million in sample ÷ RPM in no-template control) provided effective separation of true pathogens from reagent background, enabling clinically actionable reports
- Host depletion is critical for high-human-DNA samples: without effective host removal, biopsies and tissue samples consume tens of millions of reads without recovering microbial signal — making host depletion a prerequisite for cost-effective mNGS in challenging sample types
Key Takeaways
- Up to half of meningitis patients receive no confirmed microbiological diagnosis with standard methods — mNGS addresses this diagnostic gap directly
- A single clinical mNGS result can cover bacteria, fungi, viruses, and parasites simultaneously, replacing multiple separate assays that would otherwise exhaust a small sample
- Lot-matched negative controls and spike-in process controls are essential: reagent background varies by brand and lot, and false positives are most reliably excluded by system control subtraction rather than database filtering alone
- The combination of high sensitivity and broad pathogen range makes mNGS particularly valuable for ophthalmologic infections, CNS infections, and any setting where repeat sampling is not feasible
Related Resources
- mNGS Validation for Sterile Body Fluids: Methods and Results — extended summary of Dr. Adler’s validation study
- ICCMg 2024 Poster — Tel Aviv Sourasky (PDF)
- Devin Microbial Enrichment Kit
- PaRTI-Seq Analysis Platform
- TVGH Sepsis mNGS Study: PaRTI-Seq Detects 74.4% of Cases
- Host Depletion for Pathogen Identification in mNGS
