Rapid detection of invasive Mycobacterium chimaera disease via a novel plasma-based next-generation sequencing test
| Autor: | Jim H. Nomura, Brian P. Lee, Townson Tsai, Sivan Bercovici, David K. Hong, Gary Bluestone, Gunter Rieg, Dawn Terashita, Andrew Lai |
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| Rok vydání: | 2019 |
| Předmět: |
DNA
Bacterial Male 0301 basic medicine medicine.medical_specialty Mycobacterium chimaera infection 030106 microbiology Disease Gastroenterology Disease Outbreaks Mycobacterium lcsh:Infectious and parasitic diseases Cell-free DNA 03 medical and health sciences 0302 clinical medicine Medical microbiology Internal medicine Blood plasma medicine Humans lcsh:RC109-216 030212 general & internal medicine Aged Retrospective Studies Mycobacterium Infections biology business.industry High-Throughput Nucleotide Sequencing Retrospective cohort study Sequence Analysis DNA Middle Aged biology.organism_classification Infectious Diseases Parasitology Specimen collection Cell-free fetal DNA Next-generation sequencing Female Heater-cooler devices business Research Article |
| Zdroj: | BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-8 (2019) BMC Infectious Diseases |
| ISSN: | 1471-2334 |
| DOI: | 10.1186/s12879-019-4001-8 |
| Popis: | Background There is an ongoing outbreak of Mycobacterium chimaera infections among patients exposed to contaminated heater-cooler devices used during cardiac surgery. Recognition of M. chimaera infection is hampered by its long latency and non-specific symptoms. Standard diagnostic methods using acid-fast bacilli (AFB) culture often require invasive sampling, have low sensitivity, and can take weeks to result. We describe the performance of a plasma-based next-generation sequencing test (plasma NGS) for the diagnosis of M. chimaera infection. Methods We conducted a retrospective study of 10 patients with a history of cardiac surgery who developed invasive M. chimaera infection and underwent testing by plasma NGS between February 2017 and April 2018. Results Plasma NGS detected M. chimaera in 9 of 10 patients (90%) with invasive disease in a median of 4 days from specimen collection, including all 8 patients with disseminated infection. In 7 of these 9 cases (78%), plasma NGS was the first test to provide microbiologic confirmation of M. chimaera infection. In contrast, AFB cultures required a median of 20 days to turn positive, and the median time for confirmation of M. chimaera was 41 days. Of 24 AFB blood cultures obtained in this cohort, only 4 (17%) were positive. Invasive procedures were performed in 90% of cases, and in 5 patients (50%), mycobacterial growth was achieved only by culture of these deep sites. Conclusions Plasma NGS can accurately detect M. chimaera noninvasively and significantly faster than AFB culture, making it a promising new diagnostic tool. Electronic supplementary material The online version of this article (10.1186/s12879-019-4001-8) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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