Serious infections in hospitalized patients are often difficult to diagnose quickly and accurately. Conventional tests like culture and Polymerase Chain Reaction (PCR) can miss pathogens or provide incomplete answers, delaying targeted treatment and driving prolonged broad-spectrum antibiotic use. Fusion Genomics has developed ONETest, a targeted metagenomic assay that detects hundreds of pathogens and antimicrobial resistance markers in a single run. While ONETest is analytically validated, the missing piece for its use in routine care has been a clinically validated interpretive layer that tells physicians which detected organism is likely causing disease and how antimicrobial resistance should shape therapy.

This project is a partnership between Fusion Genomics and St. Paul’s Hospital to co‑develop and validate that interpretive layer. The team will implement ONETest into the St Paul’s Hospital labs and use it to evaluate high‑acuity cohorts, such as ventilated ICU pneumonia and immunocompromised patients, to compare ONETest to the standard of care.

ONETest will go beyond identifying the pathogens and will translate the data into labels like “causative”, “colonizer” or “indeterminate” to the detected pathogens, to inform clinicians which pathogens are disease causing, versus which are “bystanders”. The interpretive models will be embedded in Fusion’s secure analytics platform, FusionCloud, so validated improvements can be deployed across new hospital sites, making the technology more scalable.

By delivering faster, more actionable answers, the project aims to reduce unnecessary antibiotic use, shorten hospital stays and improve outcomes for complex patients, while building a scalable BC‑grown diagnostic capability that can be adopted across Canada and internationally.