Clinical application of cell-free next-generation sequencing for infectious diseases at a tertiary children’s hospital

Autor: Helen Harvey, Jennifer Foley, Christopher R. Cannavino, Lauge Farnaes, Nicole G. Coufal, Julianne Wilke, Nanda Ramchandar, Leidy Tovar Padua, Adriana H. Tremoulet, Alice Pong
Jazyk: angličtina
Rok vydání: 2021
Předmět:
0301 basic medicine
Male
Future studies
Cell free
Infectious and parasitic diseases
RC109-216
Medical microbiology
Child
Children
Pediatric
screening and diagnosis
Cell-free plasma
High-Throughput Nucleotide Sequencing
Hospitals
Pediatric
Hospitals
Detection
Infectious Diseases
Medical Microbiology
Child
Preschool
Infectious etiology
Female
Infection
Cell-Free Nucleic Acids
4.2 Evaluation of markers and technologies
medicine.medical_specialty
Adolescent
030106 microbiology
Clinical Sciences
Microbiology
Communicable Diseases
03 medical and health sciences
Diagnostic Tests
Clinical Research
Chart review
medicine
Humans
Routine
Intensive care medicine
Preschool
Reference standards
Retrospective Studies
business.industry
Diagnostic Tests
Routine
Research
Peripheral blood
4.1 Discovery and preclinical testing of markers and technologies
030104 developmental biology
Good Health and Well Being
Next-generation sequencing
Metagenome
Metagenomics
business
Pediatric population
Zdroj: BMC Infectious Diseases, Vol 21, Iss 1, Pp 1-6 (2021)
BMC Infectious Diseases
BMC infectious diseases, vol 21, iss 1
ISSN: 1471-2334
Popis: Background Children affected by infectious diseases may not always have a detectable infectious etiology. Diagnostic uncertainty can lead to prolonged hospitalizations, inappropriately broad or extended courses of antibiotics, invasive diagnostic procedures, and difficulty predicting the clinical course and outcome. Cell-free plasma next-generation sequencing (cfNGS) can identify viral, bacterial, and fungal infections by detecting pathogen DNA in peripheral blood. This testing modality offers the ability to test for many organisms at once in a shotgun metagenomic approach with a rapid turnaround time. We sought to compare the results of cfNGS to conventional diagnostic test results and describe the impact of cfNGS on clinical care in a diverse pediatric population at a large academic children’s hospital. Methods We performed a retrospective chart review of hospitalized subjects at a tertiary pediatric hospital to determine the diagnostic yield of cfNGS and its impact on clinical care. Results We describe the clinical application of results from 142 cfNGS tests in the management of 110 subjects over an 8-month study period. In comparison to conventional testing as a reference standard, cfNGS was found to have a positive percent agreement of 89.6% and negative percent agreement of 52.3%. Furthermore, 32.4% of cfNGS results were directly applied to make a clinical change in management. Conclusions We demonstrate the clinically utility of cfNGS in the management of acutely ill children. Future studies, both retrospective and prospective, are needed to clarify the optimal indications for testing.
Databáze: OpenAIRE
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