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Stacey emphasized the critical importance of having access to a specific test for her daughter, stating, “The fact that they had a test there available to her was paramount. It saved her life.” Russ, Willow’s father, expressed deep gratitude, describing her survival as nothing short of miraculous: “It’s a miracle she’s here and we’re extremely grateful for that.” Although Willow faced a severe infection requiring several months in the hospital, the appropriate treatment made her recovery possible.
Willow’s case is just one example of the many children who have benefited from a new type of diagnostic testing at the children’s hospital. Between 2024 and 2025, a study involving metagenomic testing evaluated 122 critically ill children in the paediatric intensive care unit (ICU) at Great Ormond Street Hospital (GOSH). The findings from this research have recently been published in the Lancet Microbe. Unlike traditional methods, metagenomic testing examines all genetic material in a sample, enabling the detection of thousands of pathogens simultaneously.
Historically, identifying bacterial infections relied on culturing bacteria on Petri dishes, a technique dating back to the Victorian era. Another common method, PCR testing, can detect viruses and some bacteria, but it requires clinicians to specify the target pathogen beforehand. However, metagenomic testing at GOSH demonstrated the ability to identify approximately 90% of bacteria and viruses, as well as all fungi present in clinical samples. In about 25% of cases, this testing directly influenced treatment decisions, including the initiation, discontinuation, or alteration of antibiotic prescriptions.
Dr. Sam Ray, a consultant in paediatric intensive care medicine at GOSH and co-author of the study, highlighted the limitations of traditional diagnostic approaches: “The study has helped us to spot infections we would have missed, get children on the right treatment and stop antibiotics when we know they aren’t going to work. Removing unnecessary treatment is incredibly important for the fight against growing antimicrobial resistance.” Additionally, metagenomic testing uncovered 50 organisms not detected through routine diagnostics, suggesting its potential as an early warning system for emerging infections. Dr. Julianne Brown, head of the GOSH Metagenomics Service and co-senior author, noted that this testing is being gradually introduced in approximately 30 intensive care units across the UK, covering both adult and paediatric care. She emphasized its future role in pandemic preparedness: “It could be a powerful tool for identifying new infections that pose a pandemic threat. In the future, if there was to be a new mystery pathogen that could be a cause of the next pandemic, we would detect that very quickly and put the right measures in place.” The GOSH initiative builds on earlier trials at Guy’s and St Thomas’ NHS Trust, which first employed metagenomics to detect respiratory infections in adult patients
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