Plasma Microbial Cell-Free DNA Sequencing Technology for the Diagnosis of Sepsis in the ICU

• DOI: 10.3389/fmolb.2021.659390
• Publication Date: 2021-05-28T11:23:26Z
• Authors: Lili Wang; Wenzheng Guo; Hui Shen; Jian Guo; Donghua Wen; Yuetian Yu; Wenjuan Wu
• Keywords: Acinetobacter baumannii; Blood Culture

Sepsis is a common life-threatening disease in the intensive care unit (ICU) that usually treated empirically without pathogen identification. As non-invasive and high-throughput technology, plasma microbial cell-free DNA (mcfDNA) sequencing can detect unknown pathogens independent of previous clinical or laboratory information. In this study, total 199 cases suspected bloodstream infection (BSI) from January 2020 to June were collected, potential detected by simultaneous blood culture mcfDNA sequencing. Other microbiological assays performed within 7 days sequencing, including smear, samples taken relevant infected sites, β-D-glucan/galactomannan (BDG/GM) tests, among others. The diagnoses classified as sepsis [94 (47.2%)], non-sepsis [87 (43.7%)], non-infectious [18 (9.0%)]. sensitivity specificity for diagnosing 68.1 63.2%, respectively, which significantly better than those culture, especially bacteria cause hospital-acquired infection, namely, Acinetobacter baumannii ( p < 0.01) Klebsiella pneumoniae 0.01), viruses (plasma only, 0.01). However, there was no significant difference rate positivity between antibiotic-non-exposed (43.6 vs. 30.9%, = 0.17). group, 44.8% (13/29) only showed infections other parts body, such lower respiratory (LRI), intra-abdominal (IAI) central nervous system (CNSI). For some (not anaerobes), turnaround time (TAT) 3 (TAT initiation sample processing nucleic acid extraction completion analysis) longer TAT1 bottles Virtuo off Virtuo). With progression, dynamic changes species clearly