Karius test as a noninvasive diagnostic tool in pediatric hematopoietic stem cell transplant patients with pneumonia: A case series

Smith, Lauren; Bliton, Kyle; Turner, Brett; Goldman, Frederick D.

doi:10.1002/ppul.26470

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…Metagenomic next-generation sequencing (Karius ® testing) of plasma cell-free DNA has emerged as an attractive diagnostic modality allowing broad-range pathogen detection, noninvasive sampling, and earlier diagnosis ( 14 ). Although the comprehensive clinical impact of this testing technique continues to be studied and further validation of the platform is needed, multiple investigations have shown its ability to identify otherwise unculturable or undetectable infections, particularly in severely immunocompromised leukemia and HCT patients ( 14 - 16 ). Specifically in the FN setting, this testing platform has shown high rates of positive agreement with culture results and reduced overall calculated time to diagnosis (TTD) compared to standard microbiological testing ( 17 ).…”

Section: Novel Diagnostic Strategiesmentioning

confidence: 99%

Fever and neutropenia in pediatric oncology and stem cell transplant patients: an editorial commentary on updated international clinical practice guidelines

Hoover,

Thielen,

Ebens

2023

Transl Pediatr

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Section: Novel Diagnostic Strategiesmentioning

confidence: 99%

Fever and neutropenia in pediatric oncology and stem cell transplant patients: an editorial commentary on updated international clinical practice guidelines

Hoover,

Thielen,

Ebens

2023

Transl Pediatr

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Plasma Microbial Cell-Free DNA Sequencing for Pathogen Detection and Quantification in Children With Musculoskeletal Infections

Wood,

Russell,

Davis

et al. 2024

Journal of the Pediatric Infectious Diseases Society

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Background Nearly half of all pediatric musculoskeletal infections (MSKIs) are culture- negative. Plasma microbial cell-free DNA (mcfDNA) sequencing is non-invasive and not prone to the barriers of culture. We evaluated the performance of plasma mcfDNA sequencing in identifying a pathogen, and examined the duration of pathogen detection in children with MSKIs. Methods We conducted a prospective study of children, aged 6 months to 18 years, hospitalized from July 2019 to May 2022 with MSKIs, in whom we obtained serial plasma mcfDNA sequencing samples and compared the results with cultures. Results A pathogen was recovered by culture in 23 of 34 (68%) participants, and by initial mcfDNA sequencing in 25 of 31 (81%) participants. Multiple pathogens were detected in the majority (56%) of positive initial samples. Complete concordance with culture (all organisms accounted for by both methods) was 32%, partial concordance (at least 1 of the same organism(s) identified by both methods) was 36%, and discordance was 32%. McfDNA sequencing was more likely to show concordance (complete or partial) if obtained prior to a surgical procedure (82%), compared with after (20%), (RR 4.12 [95% CI 1.25, 22.93], p=0.02). There was no difference in concordance based on timing of antibiotics (pre-sample antibiotics. 60% vs. no antibiotics, 75%, [RR 0.8, 95% CI 0.40, 1.46, p=0.65]). McfDNA sequencing was positive in 67% of culture-negative infections and detected a pathogen for a longer interval than blood culture (median 2 days (IQR 1, 6 days] vs. 1 day [1, 1 day], p <0.01). Conclusions Plasma mcfDNA sequencing may be useful in culture-negative pediatric MSKIs if the sample is obtained prior to surgery. However, results must be interpreted in the appropriate clinical context as multiple pathogens are frequently detected supporting the need for diagnostic stewardship.

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Deciphering the potential of plasma cell-free metagenomic next-generation sequencing using the Karius test

Bell

2023

Current Opinion in Infectious Diseases

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Purpose of review Plasma cell-free metagenomic next-generation sequencing (cf-mNGS) is increasingly employed for the diagnosis of infection, but a consensus for optimal use has not been established. This minireview focuses on the commercially available Karius Test and is aimed at local leaders seeking to understand the complexities of cf-mNGS to make informed test utilization policies and better interpret results. Recent findings Recent retrospective studies have reported how the Karius Test was applied at their institutions and identified areas of potential patient benefit. In addition, substantive studies have reported how this test performs in specific indications, particularly invasive fungal disease, endovascular infection and lower respiratory infection. Summary Successfully integrating plasma cf-mNGS requires careful assessment of performance in the specific applications and patient populations in which it is used. Individual institutions must independently evaluate implementation strategies and determine where diagnostic yields outweigh the potential pitfalls.

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Karius test as a noninvasive diagnostic tool in pediatric hematopoietic stem cell transplant patients with pneumonia: A case series

Cited by 3 publications

References 5 publications

Fever and neutropenia in pediatric oncology and stem cell transplant patients: an editorial commentary on updated international clinical practice guidelines

Fever and neutropenia in pediatric oncology and stem cell transplant patients: an editorial commentary on updated international clinical practice guidelines

Plasma Microbial Cell-Free DNA Sequencing for Pathogen Detection and Quantification in Children With Musculoskeletal Infections

Deciphering the potential of plasma cell-free metagenomic next-generation sequencing using the Karius test

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