Utility of Microbial Cell Free DNA Next-Generation Sequencing for Diagnosis and Management of Infectious Diseases

Microbial cell-free DNA (mcfDNA) sequencing is a promising tool to identify infectious pathogens when traditional methods fail to identify the causative agent. We performed a retrospective observational cohort study to evaluate clinical outcomes among pediatric and adult patients who underwent mcfDNA testing. 127 mcfDNA tests were reviewed from 112 patients. Baseline characteristics included 61 (54.5%) adults, 52 (40.9%) tests were from female patients, and 67 (52.8%) tests were obtained from patients designated as immunocompromised. Of all tests obtained, 59 (46.4%) were deemed clinically relevant. 41 (32.3%) of tests also led to a change in antimicrobial management for the corresponding patient. No statistically significant association was ascertained between patient-specific factors and clinically relevant test results. Testing in certain clinical scenarios or high-risk settings may be useful, however further studies are needed to assess the cost-benefit of this approach.