Community-acquired pneumonia in children: cell-free plasma sequencing for diagnosis and management

Diagn Microbiol Infect Dis. 2019 Jun;94(2):188-191. doi: 10.1016/j.diagmicrobio.2018.12.016. Epub 2019 Feb 2.

Abstract

Community-acquired pneumonia (CAP) is a common cause of pediatric hospital admission. Empiric antibiotic therapy for hospitalized children with serious CAP now targets the most likely pathogen(s), including those that may demonstrate significant antibiotic resistance. Cell-free plasma next-generation sequencing (CFPNGS) was first made available for Pediatric Infectious Diseases physicians in June 1, 2017, to supplement standard-of-care diagnostic techniques. A retrospective chart review was performed for children hospitalized with CAP between June 1, 2017, and January 22, 2018, to evaluate the impact of CFPNGS. We identified 15 hospitalized children with CAP without other underlying medical conditions for whom CFPNGS was performed. CFPNGS identified a pathogen in 13 of 15 (86%) children compared with 47% for those using standard culture and PCR-based methods alone. Changes in antibiotic management were made in 7 of 15 (47%) of children as a result of CFPNGS.

Keywords: Cell-free plasma sequencing; Infectious disease; NGS; Pediatric; Pneumonia; Precision medicine.

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Bacteria / drug effects
  • Bacteria / genetics
  • Bacteria / isolation & purification*
  • Child
  • Child, Preschool
  • Community-Acquired Infections / diagnosis*
  • Community-Acquired Infections / drug therapy
  • DNA, Bacterial / genetics
  • DNA, Bacterial / isolation & purification*
  • Disease Management
  • Female
  • High-Throughput Nucleotide Sequencing / methods*
  • Humans
  • Infant
  • Male
  • Molecular Diagnostic Techniques / methods*
  • Plasma / chemistry*
  • Pneumonia, Bacterial / diagnosis*
  • Pneumonia, Bacterial / drug therapy
  • Retrospective Studies

Substances

  • Anti-Bacterial Agents
  • DNA, Bacterial