Microbial Cell-Free DNA Identifies Etiology of Bloodstream Infections, Persists Longer Than Conventional Blood Cultures, and Its Duration of Detection Is Associated With Metastatic Infection in Patients With Staphylococcus aureus and Gram-Negative Bacteremia
| Autor: | Asim A. Ahmed, Felicia Ruffin, Erick R Scott, Batu K. Sharma-Kuinkel, Desiree H Hollemon, Hon Seng, Nicholas R. Degner, Lily Blair, Lisa Wanda, Lawrence P. Park, Carine Ho, Emily M. Eichenberger, Pratik Shah, Vance G. Fowler, David S. Hong, Timothy A. Blauwkamp, Christiaan R de Vries |
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| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Staphylococcus aureus Bacteremia medicine.disease_cause Gastroenterology Internal medicine Sepsis medicine Humans Blood culture Pathogen medicine.diagnostic_test business.industry Odds ratio Staphylococcal Infections medicine.disease Confidence interval Major Articles and Commentaries Infectious Diseases Cell-free fetal DNA Blood Culture Etiology business Cell-Free Nucleic Acids |
| Zdroj: | Clin Infect Dis |
| ISSN: | 1537-6591 |
| Popis: | Background Microbial cell-free DNA (mcfDNA) sequencing of plasma can identify the presence of a pathogen in a host. In this study, we evaluated the duration of pathogen detection by mcfDNA sequencing vs conventional blood culture in patients with bacteremia. Methods Blood samples from patients with culture-confirmed bloodstream infection were collected within 24 hours of the index positive blood culture and 48 to 72 hours thereafter. mcfDNA was extracted from plasma, and next-generation sequencing was applied. Reads were aligned against a curated pathogen database. Statistical significance was defined with Bonferroni adjustment for multiple comparisons (P Results A total of 175 patients with Staphylococcus aureus bacteremia (n = 66), gram-negative bacteremia (n = 74), or noninfected controls (n = 35) were enrolled. The overall sensitivity of mcfDNA sequencing compared with index blood culture was 89.3% (125 of 140), and the specificity was 74.3%. Among patients with bacteremia, pathogen-specific mcfDNA remained detectable for significantly longer than conventional blood cultures (median 15 days vs 2 days; P Conclusions Pathogen mcfDNA identified the bacterial etiology of bloodstream infection for a significantly longer interval than conventional cultures, and its duration of detection was associated with increased risk for metastatic infection. mcfDNA could play a role in the diagnosis of partially treated endovascular infections. |
| Databáze: | OpenAIRE |
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