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

BMC Infectious Diseases

Jennifer Foley¹  Lauge Farnaes¹  Adriana Tremoulet²  Julianne Wilke²  Christopher Cannavino²  Nicole G. Coufal²  Helen Harvey²  Nanda Ramchandar²  Alice Pong²  Leidy Tovar Padua² 

[1] Department of Pediatrics, Rady Children’s Hospital of San Diego, San Diego, USA;Department of Pediatrics, University of California, 3020 Children’s Way, 92123, San Diego, CA, USA;Department of Pediatrics, Rady Children’s Hospital of San Diego, San Diego, USA;

关键词: Metagenomics;    Cell-free plasma;    Next-generation sequencing;    Children;   

DOI  :  10.1186/s12879-021-06292-4

来源: Springer

【 摘 要 】

BackgroundChildren 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.MethodsWe 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.ResultsWe 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.ConclusionsWe 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.

【 授权许可】

CC BY