scholarly journals 645. Rapid Diagnosis of Disseminated Mycobacterium kansasii infection in Renal Transplant Recipients Using Plasma Microbial Cell Free DNA Next Generation Sequencing

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S424-S425
Author(s):  
Tosin Ogunsiakan ◽  
Kristen D Fajgenbaum ◽  
Gautam Phadke ◽  
Thomas Montgomery ◽  
Kiran Gajurel
Keyword(s):  
Next Generation Sequencing ◽  
Transplant Recipient ◽  
Kidney Transplant ◽  
Kidney Transplant Recipient ◽  
Rapid Diagnosis ◽  
Mycobacterium Kansasii ◽  
Transplant Recipients ◽  
Next Generation ◽  
Free Dna ◽  
Generation Sequencing

Abstract Background Disseminated Mycobacterium kansasii infection is rare in kidney transplant recipients. The diagnosis may not be suspected readily due to non-specific clinical presentation. The diagnosis and treatment can be further delayed due to poor sensitivity of culture (especially of extra-pulmonary sites) and slow growth in culture media. Accurate and rapid diagnosis of disseminated M. kansasii infections in transplant recipients is important for antimicrobial management. Methods Two cases of disseminated M. kansasii infections with unusual presentation in which rapid diagnosis was made using the Karius test (KT) are presented. The KT is a CLIA certified/CAP-accredited next-generation sequencing (NGS) plasma test that detects microbial cell-free DNA (mcfDNA). After mcfDNA is extracted and NGS performed, human reads are removed, and remaining sequences are aligned to a curated database of >1400 organisms. Organisms present above a statistical threshold are reported. Results Case 1: A 31-year female kidney transplant recipient presented with a thyroglossal duct cyst, as well as swelling of her right metacarpophalangeal joint and left 3rd finger. AFB culture of the thyroglossal cyst aspiration done on post admission day (PAD) 2 took 27 days to be identified as M. kansasii (on PAD 29) whereas plasma sent for KT on PAD 5 reported a positive test for M. kansasii at 284 molecules/microliter (MPM) in 4 days (on PAD 9). Case 2: A 59-year male kidney transplant recipient presented with generalized weakness, arthralgia, pericardial effusion, cytopenia, weight loss and intermittent fevers. Plasma sent for KT on PAD 12 was reported positive for M. kansasii at 1314 MPM in 3 days (on PAD 15). PET CT done simultaneously was consistent with an infection of an old AV graft in the left upper extremity. The AFB culture of the resected graft was confirmed as M. kansasii in 22 days on PAD 36. After the KT was available (before confirmation of M. kansasii on culture), the first patient underwent modification of empiric treatment and the second patient was started on specific treatment for M. kansasii. Table of M. kansasii cases Rapid diagnosis of disseminated M. kansasii infection Conclusion Open-ended NGS plasma testing for mcfDNA identified disseminated M kansasii infection much earlier than standard microbiology and thus helped in initiation and modification of pathogen directed treatment. Disclosures All Authors: No reported disclosures

scholarly journals 670. Rapid, Non-invasive Detection of Invasive Mycoplasma hominis Infection using the Karius Test, A Next-Generation Sequencing Test for Microbial Cell-free DNA in Plasma

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S390-S390
Author(s):  
Priya Edward ◽  
William V La Via ◽  
Mehreen Arshad ◽  
Kiran Gajurel
Keyword(s):  
Next Generation Sequencing ◽  
Case Series ◽  
Mycoplasma Hominis ◽  
Microbial Cell ◽  
Next Generation ◽  
Cell Free Dna ◽  
Non Invasive ◽  
Free Dna ◽  
Hominis Infection ◽  
Generation Sequencing

Abstract Background Mycoplasma hominis is typically associated with genital infections in women and is a rare cause of musculoskeletal infections often in immunocompromised hosts. Diagnosis of invasive Mycoplasma hominis infections are difficult due to challenges in culturing these organisms. Molecular diagnostics require an index of suspicion which may not be present at the time of tissue sampling. Accurate, rapid diagnosis of Mycoplasma hominis infections are important for antibiotic management. Methods Two cases of invasive Mycoplasma hominis infections are presented in which the Karius test (KT) was used to make the diagnosis. The KT is a CLIA certified/CAP-accredited next-generation sequencing (NGS) plasma test that detects microbial cell-free DNA (mcfDNA). After mcfDNA is extracted and NGS performed, human reads are removed and remaining sequences are aligned to a curated database of > 1400 organisms. Organisms present above a statistical threshold are reported. Case review was performed for clinical correlation. Results A young woman with lupus nephritis status post renal transplant developed persistent fever with progressive multifocal culture-negative osteoarticular infection despite empiric ceftriaxone. An adolescent female presented with an ascending pelvic infection progressing to purulent polymicrobial peritonitis (see table) requiring surgical debridement and cefipime, metronidazole and micafungin therapy; her course was complicated by progressive peritonitis/abscesses. Karius testing detected high-levels of Mycoplasma hominis mcfDNA in both cases – at 3251 molecules/microliter (MPM) in the first case and 3914 MPM in the second case. The normal range of Mycoplasma hominis mcfDNA in a cohort of 684 normal adults is 0 MPM. The patients rapidly improved with atypical coverage with doxycycline and levofloxaxin. Clinical findings in 2 patients with M. hominis infection detected by the Karius Test Conclusion Open-ended, plasma-based NGS for mcfDNA provides a rapid, non-invasive method to diagnose invasive Mycoplasma hominis infection. This case series highlights the potential to diagnose infections caused by fastidious pathogens to better inform antimicrobial therapy and achieve favorable outcomes. Disclosures William V. La Via, MD, Karius (Employee)

scholarly journals Early solid tumor diagnosis through next-generation sequencing of cell-free DNA

2018 ◽  
Vol 12 (11) ◽  
pp. 1197-1201
Author(s):  
Demosthenes E Ziogas ◽  
Ioannis D Kyrochristos ◽  
Efstathios G Lykoudis ◽  
Dimitrios H Roukos
Keyword(s):  
Next Generation Sequencing ◽  
Solid Tumor ◽  
Tumor Diagnosis ◽  
Next Generation ◽  
Cell Free Dna ◽  
Free Dna ◽  
Generation Sequencing

scholarly journals FusariumInfection in a Kidney Transplant Recipient Successfully Treated with Voriconazole

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Ahmed M. Alkhunaizi ◽  
Ali M. Bazzi ◽  
Ali A. Rabaan ◽  
Elwaleed A. Ahmed
Keyword(s):  
Transplant Recipient ◽  
Kidney Transplant ◽  
High Mortality ◽  
Kidney Transplant Recipient ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Solid Organ Transplant Recipients

Fusariuminfections in solid-organ transplant recipients are rare and carry high mortality. We report a case of a kidney transplant recipient who developed infection withFusariumspecies. The patient received treatment with oral voriconazole for five months with good response.

scholarly journals Next-generation sequencing of microbial cell-free DNA for rapid noninvasive diagnosis of infectious diseases in immunocompromised hosts

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1194 ◽  
Author(s):  
Jose F. Camargo ◽  
Asim A. Ahmed ◽  
Martin S. Lindner ◽  
Michele I. Morris ◽  
Shweta Anjan ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Invasive Aspergillosis ◽  
Noninvasive Diagnosis ◽  
Cell Transplant ◽  
Next Generation ◽  
Cell Free Dna ◽  
Hematopoietic Stem ◽  
Free Dna ◽  
Immunocompromised Hosts ◽  
Generation Sequencing

Background: Cell-free DNA (cfDNA) sequencing has emerged as an effective laboratory method for rapid and noninvasive diagnosis in prenatal screening testing, organ transplant rejection screening, and oncology liquid biopsies but clinical experience for use of this technology in diagnostic evaluation of infections in immunocompromised hosts is limited.  Methods: We conducted an exploratory study using next-generation sequencing (NGS) for detection of microbial cfDNA in a cohort of ten immunocompromised patients with febrile neutropenia, pneumonia or intra-abdominal infection.  Results: Pathogen identification by cfDNA NGS demonstrated positive agreement with conventional diagnostic laboratory methods in 7 (70%) cases, including patients with proven/probable invasive aspergillosis, Pneumocystis jirovecii pneumonia, Stenotrophomonas maltophilia bacteremia, Cytomegalovirus and Adenovirus viremia. NGS results were discordant in 3 (30%) cases including two patients with culture negative sepsis who had undergone hematopoietic stem cell transplant in whom cfDNA testing identified the etiological agent of sepsis; and one kidney transplant recipient with invasive aspergillosis who had received >6 months of antifungal therapy prior to NGS testing. Conclusion: These observations support the clinical utility of measurement of microbial cfDNA sequencing from peripheral blood for rapid noninvasive diagnosis of infections in immunocompromised hosts. Larger studies are needed.

scholarly journals P2.01-008 SiRe Next Generation Sequencing Panel: Effective Diagnostic Tool for Circulating Free DNA Analysis

2017 ◽  
Vol 12 (1) ◽  
pp. S787-S788
Author(s):  
Umberto Malapelle ◽  
Clara Mayo ◽  
Danilo Rocco ◽  
Monica Garzon ◽  
Pasquale Pisapia ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Diagnostic Tool ◽  
Dna Analysis ◽  
Next Generation ◽  
Circulating Free Dna ◽  
Free Dna ◽  
Generation Sequencing

scholarly journals Identification of an Emergent Pathogen, Bartonella vinsonii, Using Next-Generation Sequencing in a Patient With Culture-Negative Endocarditis

2020 ◽  
Author(s):  
Rachel D Downey ◽  
Susan M Russo ◽  
Sarmistha B Hauger ◽  
Donald K Murphey ◽  
Grace Marx ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Immunohistochemical Staining ◽  
Next Generation ◽  
Chain Reaction ◽  
Valve Tissue ◽  
Free Dna ◽  
Emergent Pathogen ◽  
Polymerase Chain ◽  
Culture Negative ◽  
Generation Sequencing

Abstract Diagnosis and treatment of culture negative endocarditis remains a challenge. This report describes a rare cause of endocarditis in humans, Bartonella vinsonii, identified through next generation sequencing of plasma microbial cell-free DNA with confirmation of cardiac valve tissue infection through immunohistochemical staining and polymerase chain reaction.

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