ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Microbial Cell-Free DNA Identifies the Causative Pathogen in Infective Endocarditis and Remains Detectable Longer Than Conventional Blood Culture in Patients with Prior Antibiotic Therapy.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 1 of them a synthesis that pooled it.
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Who cites it
49 citing papers in PubMed, 1 synthesis or guideline pooled it, 76 citations in OpenAlex.
- Blood Culture-Negative Endocarditis: A Scientific Statement From the American Heart Association:Journal of the American Heart Association · 2025Guideline
- 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
- Review
- Metagenomic next-generation sequencing in blood culture-negative endocarditis: a structured review with illustrative pooled estimates.Infection · 2026Review
- Plasma metagenomic sequencing testing for diagnosis of invasive fungal infection in children and young adults.Microbiology spectrum · 2026Article
- Current Surgical Approaches to Managing Infective Endocarditis With Aortic Root Abscess.Reviews in cardiovascular medicine · 2026Review
- Microbial cell-free DNA for rapid pathogen identification in clinical diagnostics: a proof of concept study.Genome medicine · 2026Article
- Microbial Cell-Free DNA Sequencing as a Novel Diagnostic for Culture-Negative Gemella haemolysans Endocarditis.JACC. Case reports · 2026Article
- Diffuse neuroinflammation and immature neuron loss in fetal Rhesus macaques after short-term intrauterine infection.Journal of neuroinflammation · 2026Article
- Mindful diagnostics in culture-negative endocarditis: early noninvasive diagnosis ofAntimicrobial stewardship & healthcare epidemiology : ASHE · 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
- Article
- Next-Generation Sequencing for Bloodstream Infections: Shaping the Future of Rapid Diagnostics and Precision Medicine.Diagnostics (Basel, Switzerland) · 2025Review
- Quantitative Microbial Cell-Free DNA Sequencing From Plasma: A Potential Biomarker for the Diagnosis of Staphylococcal Infection of Cardiac Implantable Electronic Devices.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Ultra-broad hybrid capture-based targeted next-generation sequencing for sensitive plasma pathogen cfDNA detection in bloodstream infections.Journal of translational medicine · 2025Article
- Next-Generation Sequencing Techniques to Diagnose Culture-Negative Subacute Native Aortic Endocarditis.Emerging infectious diseases · 2025Article
- Infective Endocarditis During Pregnancy: Challenges and Future Directions.Journal of clinical medicine · 2025Review
- From Culture-Negative to DNA-Positive: The Molecular Revolution in Infective Endocarditis Diagnosis.Pathogens (Basel, Switzerland) · 2025Review
- Illuminating the Challenges and Diagnostic Utility of Plasma Microbial Cell-Free DNA Sequencing in Suspected Infective Endocarditis: A Retrospective Observational Cohort Study.Open forum infectious diseases · 2025Article
- Molecular Diagnostics for Invasive Molds: From Lab to Bedside.Clinics in laboratory medicine · 2025Review
Corrections and comments
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Authors and funding
17 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe diagnosis of infective endocarditis (IE) can be difficult, particularly if blood cultures fail to yield a pathogen. This study evaluates the potential utility of microbial cell-free DNA (mcfDNA) as a tool to identify the microbial etiology of IE.
methodsBlood samples from patients with suspected IE were serially collected. mcfDNA was extracted from plasma and underwent next-generation sequencing. Reads were aligned against a library containing DNA sequences belonging to >1400 different pathogens. mcfDNA from organisms present above a statistical threshold were reported and quantified in molecules per milliliter (MPM). Additional mcfDNA was collected on each subject every 2-3 days for a total of 7 collections or until discharge.
resultsOf 30 enrolled patients with suspected IE, 23 had definite IE, 2 had possible IE, and IE was rejected in 5 patients by modified Duke Criteria. Only the 23 patients with definite IE were included for analysis. Both mcfDNA and blood cultures achieved a sensitivity of 87%. The median duration of positivity from antibiotic treatment initiation was estimated to be approximately 38.1 days for mcfDNA versus 3.7 days for blood culture (proportional odds, 2.952; P = .02771), using a semiparametric survival analysis. mcfDNA (log10) levels significantly declined (-0.3 MPM log10 units, 95% credible interval -0.45 to -0.14) after surgical source control was performed (pre- vs postprocedure, posterior probability >0.99).
conclusionmcfDNA accurately identifies the microbial etiology of IE. Sequential mcfDNA levels may ultimately help to individualize therapy by estimating a patient's burden of infection and response to treatment.
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