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dc.contributor.authorShishido, Akira A
dc.contributor.authorNoe, Myint
dc.contributor.authorSaharia, Kapil
dc.contributor.authorLuethy, Paul
dc.date.accessioned2022-04-18T15:20:22Z
dc.date.available2022-04-18T15:20:22Z
dc.date.issued2022-04-13
dc.identifier.urihttp://hdl.handle.net/10713/18603
dc.description.abstractBACKGROUND: Metagenomic next-generation sequencing of microbial cell-free DNA (mcfDNA) allows for non-invasive pathogen detection from plasma. However, there is little data describing the optimal role for this assay in real-world clinical decision making. METHODS: We performed a single-center retrospective cohort study of adult patients for whom a mcfDNA (Karius©) test was sent between May 2019 and February 2021. Clinical impact was arbitrated after review and discussion of each case. RESULTS: A total of 80 patients were included. The most common reason for sending the assay was unknown microbiologic diagnosis (78%), followed by avoiding invasive procedures (14%). The test had a positive impact in 34 (43%), a negative impact in 2 (3%), and uncertain or no impact in 44 (55%). A positive impact was observed in solid organ transplant recipients (SOTR, 71.4%, p = 0.003), sepsis (71.4%, p = 0.003), and those receiving antimicrobial agents for less than 7 days prior to mcfDNA testing (i.e., 61.8%, p = 0.004). Positive impact was driven primarily by de-escalation of antimicrobial therapy. CONCLUSION: Clinical impact of mcfDNA testing was highest in SOTR, patients with sepsis and patients who had been on antimicrobial therapy for less than 7 days. Positive impact was driven by de-escalation of antimicrobial therapy which may highlight a potential role for mcfDNA in the realm of stewardship.en_US
dc.description.urihttps://doi.org/10.1186/s12879-022-07357-8en_US
dc.language.isoenen_US
dc.publisherSpringer Natureen_US
dc.relation.ispartofBMC Infectious Diseasesen_US
dc.rights© 2022. The Author(s).en_US
dc.subjectCell-free DNAen_US
dc.subjectKarius©en_US
dc.subjectNext-generation sequencingen_US
dc.subjectSepsisen_US
dc.subjectTransplant infectious diseaseen_US
dc.titleClinical impact of a metagenomic microbial plasma cell-free DNA next-generation sequencing assay on treatment decisions: a single-center retrospective study.en_US
dc.typeArticleen_US
dc.identifier.doi10.1186/s12879-022-07357-8
dc.identifier.pmid35418022
dc.source.journaltitleBMC infectious diseases
dc.source.volume22
dc.source.issue1
dc.source.beginpage372
dc.source.endpage
dc.source.countryEngland


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