Retrospective analysis of 300 microbial cell-free DNA sequencing results in routine blood stream infection diagnostics
IntroductionBloodstream infections are a critical challenge worldwide due to the slow turnaround time of conventional microbiological tests for detecting bacteremia in septic patients. Noscendo GmbH (Duisburg, Germany) has developed the CE/IVD pipeline DISQVER for clinical metagenomics testing based...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Cellular and Infection Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcimb.2025.1504262/full |
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| author | Claudio Neidhöfer Claudio Neidhöfer Niklas Klein Niklas Klein Aylin Yürüktümen Tessa Hattenhauer Rebekka Mispelbaum Christian Bode Tobias A. W. Holderried Achim Hoerauf Marijo Parčina |
| author_facet | Claudio Neidhöfer Claudio Neidhöfer Niklas Klein Niklas Klein Aylin Yürüktümen Tessa Hattenhauer Rebekka Mispelbaum Christian Bode Tobias A. W. Holderried Achim Hoerauf Marijo Parčina |
| author_sort | Claudio Neidhöfer |
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| description | IntroductionBloodstream infections are a critical challenge worldwide due to the slow turnaround time of conventional microbiological tests for detecting bacteremia in septic patients. Noscendo GmbH (Duisburg, Germany) has developed the CE/IVD pipeline DISQVER for clinical metagenomics testing based on cell-free DNA (cfDNA) from blood samples to address this issue.MethodsWe conducted a retrospective study to evaluate the diagnostic utility of this methodological setup in improving treatment decisions since it was introduced into our clinical setting. Between January 2021 and June 2022, the first 300 cases in which DISQVER was applied at our university hospital were collected and analyzed. The results were compared with routine microbiology test results, clinical picture, associated treatment decisions, and clinical course.ResultsOur findings demonstrate that DISQVER results where no pathogen was reported effectively ruled out bacterial bloodstream infections, whereas positive results varied in their usefulness. While the metagenomic approach proved highly valuable for detecting non-culturable and rare pathogens, its utility was limited in cases where detected microorganisms were commonly associated with the microbiota.DiscussionPerforming on-site analysis might mitigate delays resulting from logistical challenges and might help optimizing antibiotic stewardship. Once prompt results can be obtained, the relevance of incorporating molecular resistograms will become more pronounced. Further, the specific patient subgroups that most benefit from this analysis must be worked out. Guiding clinicians in identifying the infection focus based on the detected bacteria would significantly improve patient care. Lastly, evidence of filamentous fungi must be diligently followed up. |
| format | Article |
| id | doaj-art-cf21c4c514da4570a4312b26ebc82de9 |
| institution | Kabale University |
| issn | 2235-2988 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cellular and Infection Microbiology |
| spelling | doaj-art-cf21c4c514da4570a4312b26ebc82de92025-01-30T06:22:39ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882025-01-011510.3389/fcimb.2025.15042621504262Retrospective analysis of 300 microbial cell-free DNA sequencing results in routine blood stream infection diagnosticsClaudio Neidhöfer0Claudio Neidhöfer1Niklas Klein2Niklas Klein3Aylin Yürüktümen4Tessa Hattenhauer5Rebekka Mispelbaum6Christian Bode7Tobias A. W. Holderried8Achim Hoerauf9Marijo Parčina10Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn, Bonn, GermanyInstitute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, GermanyInstitute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, GermanyDepartment of Microbiology and Hospital Hygiene, Bundeswehr Central Hospital Koblenz, Koblenz, GermanyDepartment of Internal Medicine II, University Hospital Bonn, Bonn, GermanyDepartment of Hematology, Oncology, Stem Cell Transplantation, Immune and Cell Therapy, Clinical Immunology and Rheumatology, University Hospital Bonn, Bonn, GermanyDepartment of Hematology, Oncology, Stem Cell Transplantation, Immune and Cell Therapy, Clinical Immunology and Rheumatology, University Hospital Bonn, Bonn, GermanyDepartment of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, GermanyDepartment of Hematology, Oncology, Stem Cell Transplantation, Immune and Cell Therapy, Clinical Immunology and Rheumatology, University Hospital Bonn, Bonn, GermanyInstitute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, GermanyInstitute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, GermanyIntroductionBloodstream infections are a critical challenge worldwide due to the slow turnaround time of conventional microbiological tests for detecting bacteremia in septic patients. Noscendo GmbH (Duisburg, Germany) has developed the CE/IVD pipeline DISQVER for clinical metagenomics testing based on cell-free DNA (cfDNA) from blood samples to address this issue.MethodsWe conducted a retrospective study to evaluate the diagnostic utility of this methodological setup in improving treatment decisions since it was introduced into our clinical setting. Between January 2021 and June 2022, the first 300 cases in which DISQVER was applied at our university hospital were collected and analyzed. The results were compared with routine microbiology test results, clinical picture, associated treatment decisions, and clinical course.ResultsOur findings demonstrate that DISQVER results where no pathogen was reported effectively ruled out bacterial bloodstream infections, whereas positive results varied in their usefulness. While the metagenomic approach proved highly valuable for detecting non-culturable and rare pathogens, its utility was limited in cases where detected microorganisms were commonly associated with the microbiota.DiscussionPerforming on-site analysis might mitigate delays resulting from logistical challenges and might help optimizing antibiotic stewardship. Once prompt results can be obtained, the relevance of incorporating molecular resistograms will become more pronounced. Further, the specific patient subgroups that most benefit from this analysis must be worked out. Guiding clinicians in identifying the infection focus based on the detected bacteria would significantly improve patient care. Lastly, evidence of filamentous fungi must be diligently followed up.https://www.frontiersin.org/articles/10.3389/fcimb.2025.1504262/fullsepsisbacteremiablood culturemolecular diagnostic techniquesnext generation sequencingclinical metagenomics |
| spellingShingle | Claudio Neidhöfer Claudio Neidhöfer Niklas Klein Niklas Klein Aylin Yürüktümen Tessa Hattenhauer Rebekka Mispelbaum Christian Bode Tobias A. W. Holderried Achim Hoerauf Marijo Parčina Retrospective analysis of 300 microbial cell-free DNA sequencing results in routine blood stream infection diagnostics Frontiers in Cellular and Infection Microbiology sepsis bacteremia blood culture molecular diagnostic techniques next generation sequencing clinical metagenomics |
| title | Retrospective analysis of 300 microbial cell-free DNA sequencing results in routine blood stream infection diagnostics |
| title_full | Retrospective analysis of 300 microbial cell-free DNA sequencing results in routine blood stream infection diagnostics |
| title_fullStr | Retrospective analysis of 300 microbial cell-free DNA sequencing results in routine blood stream infection diagnostics |
| title_full_unstemmed | Retrospective analysis of 300 microbial cell-free DNA sequencing results in routine blood stream infection diagnostics |
| title_short | Retrospective analysis of 300 microbial cell-free DNA sequencing results in routine blood stream infection diagnostics |
| title_sort | retrospective analysis of 300 microbial cell free dna sequencing results in routine blood stream infection diagnostics |
| topic | sepsis bacteremia blood culture molecular diagnostic techniques next generation sequencing clinical metagenomics |
| url | https://www.frontiersin.org/articles/10.3389/fcimb.2025.1504262/full |
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