ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
Plasma Microbial Cell-free DNA Next-generation Sequencing in the Diagnosis and Management of Febrile Neutropenia.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02912117 (Determining the Etiologic Diagnosis in Febrile Neutropenia Using the Karius Sequencing-based Infectious Disease Diagnostic Assay), which is not on this map. Cited by 66 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Determining the Etiologic Diagnosis in Febrile Neutropenia Using the Karius Sequencing-based Infectious Disease Diagnostic Assay
Who cites it
66 citing papers in PubMed, 1 synthesis or guideline pooled it, 122 citations in OpenAlex.
- Clinical and diagnostic values of metagenomic next-generation sequencing for infection in hematology patients: a systematic review and meta-analysis.BMC infectious diseases · 2024Pooled it
- Diagnostic value of plasma cell-free DNA metagenomic next-generation sequencing in patients with suspected infections and exploration of clinical scenarios-a retrospective study from a single center.Annals of medicine · 2026Article
- Plasma Microbial Cell-Free DNA Sequencing for the Diagnosis of Chronic Disseminated Candidiasis in Patients with Hematologic Malignancies.Open forum infectious diseases · 2026Article
- Improving the Precision of Etiological Diagnosis in Bacterial Infections Using Molecular Technologies: A Comparative Analysis of Platforms, AI Integration, and Point-of-Care Deployment.International journal of molecular sciences · 2026Review
- Article
- Cell-free DNA metagenomic next generation sequencing for the diagnosis of infectious diseases: a retrospective assessment of clinical utility in a tertiary and quaternary care facility.Frontiers in microbiology · 2026Article
- Refining the Clinical Utility of Plasma Microbial Cell-Free DNA Sequencing in High-Risk Population of Infection: A Narrative Review.Infection and drug resistance · 2026Review
- Pulmonary Nocardiosis Diagnosed by Plasma Metagenomic Next-Generation Sequencing in a Patient With Recurrent Febrile Neutropenia.Case reports in infectious diseases · 2026Article
- Plasma Microbial Cell-free DNA Metagenomic Sequencing for Diagnosis of Invasive Fungal Diseases Among High-risk Outpatient and Inpatient Immunocompromised Hosts.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- In-matrix library preparation for metagenomic sequencing of microbial cell-free DNA.Journal of clinical microbiology · 2025Article
- Ultra-broad hybrid capture-based targeted next-generation sequencing for sensitive plasma pathogen cfDNA detection in bloodstream infections.Journal of translational medicine · 2025Article
- Clinical Utility of Plasma Microbial Cell-Free DNA Surveillance in Neutropenic Patients with Acute Myeloid Leukemia Undergoing Outpatient Chemotherapy: A Case Series.Diagnostics (Basel, Switzerland) · 2025Article
- Metagenomic Next-generation Sequencing Compared With Blood Culture as First-line Diagnostic Method for Bloodstream Infection in Hematologic Patients With Febrile Neutropenia: A Multicenter, Prospective Study.Open forum infectious diseases · 2025Article
- Genomics for antimicrobial resistance-progress and future directions.Antimicrobial agents and chemotherapy · 2025Review
- Metagenomic Next-generation Sequencing in Patients With Infectious Meningoencephalitis: A Comprehensive Systematic Literature Review and Meta-analysis.Open forum infectious diseases · 2025Article
- 2024 update of the AGIHO guideline on diagnosis and empirical treatment of fever of unknown origin (FUO) in adult neutropenic patients with solid tumours and hematological malignancies.The Lancet regional health. Europe · 2025Review
- Molecular Diagnostics for Invasive Molds: From Lab to Bedside.Clinics in laboratory medicine · 2025Review
- Mucormycosis.Infectious disease clinics of North America · 2025Review
- From Chart Biopsy to Liquid Biopsy: Evaluating the Diagnostic Yield and Clinical Impact of Plasma Microbial Cell-Free DNA Next-Generation Sequencing in the Management of Fever of Unknown Origin.Open forum infectious diseases · 2025Article
- Enhancing fever of unknown origin diagnosis: machine learning approaches to predict metagenomic next-generation sequencing positivity.Frontiers in cellular and infection microbiology · 2025Article
6 more citing papers are in PubMed but not listed here.
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Authors and funding
18 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStandard testing fails to identify a pathogen in most patients with febrile neutropenia (FN). We evaluated the ability of the Karius microbial cell-free DNA sequencing test (KT) to identify infectious etiologies of FN and its impact on antimicrobial management.
methodsThis prospective study (ClinicalTrials.gov; NCT02912117) enrolled and analyzed 55 patients with FN. Up to 5 blood samples were collected per subject within 24 hours of fever onset (T1) and every 2 to 3 days. KT results were compared with blood culture (BC) and standard microbiological testing (SMT) results.
resultsPositive agreement was defined as KT identification of ≥1 isolate also detected by BC. At T1, positive and negative agreement were 90% (9/10) and 31% (14/45), respectively; 61% of KT detections were polymicrobial. Clinical adjudication by 3 independent infectious diseases specialists categorized Karius results as: unlikely to cause FN (N = 0); definite (N = 12): KT identified ≥1 organism also found by SMT within 7 days; probable (N = 19): KT result was compatible with a clinical diagnosis; possible (N = 10): KT result was consistent with infection but not considered a common cause of FN. Definite, probable, and possible cases were deemed true positives. Following adjudication, KT sensitivity and specificity were 85% (41/48) and 100% (14/14), respectively. Calculated time to diagnosis was generally shorter with KT (87%). Adjudicators determined real-time KT results could have allowed early optimization of antimicrobials in 47% of patients, by addition of antibacterials (20%) (mostly against anaerobes [12.7%]), antivirals (14.5%), and/or antifungals (3.6%); and antimicrobial narrowing in 27.3% of cases. CLINICAL TRIALS REGISTRATION: NCT02912117.
conclusionKT shows promise in the diagnosis and treatment optimization of FN.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.