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

Lauge Farnaes1, Julianne Wilke2, Kathleen Ryan Loker3

  • 1University of California San Diego, Department of Pediatrics, Division of Infectious Disease; Rady Children's Institute of Genomic Medicine.

Diagnostic Microbiology and Infectious Disease
|March 2, 2019
PubMed

Insights

Cell-free plasma next-generation sequencing (CFPNGS) significantly improves pathogen detection in pediatric community-acquired pneumonia (CAP). This advanced diagnostic method led to altered antibiotic management in nearly half of hospitalized children.

Area of Science:

  • Pediatric Infectious Diseases
  • Molecular Diagnostics
  • Genomic Medicine

Background:

  • Community-acquired pneumonia (CAP) is a leading cause of pediatric hospitalizations.
  • Accurate and rapid pathogen identification is crucial for effective antibiotic therapy in severe CAP.
  • Antibiotic resistance poses a significant challenge in managing pediatric CAP.

Purpose of the Study:

  • To evaluate the impact of cell-free plasma next-generation sequencing (CFPNGS) on diagnosing pediatric CAP.
  • To compare the diagnostic yield of CFPNGS with standard-of-care methods.
  • To assess changes in antibiotic management resulting from CFPNGS use.

Main Methods:

  • Retrospective chart review of children hospitalized with CAP between June 2017 and January 2018.
  • Analysis of data from 15 pediatric patients who underwent CFPNGS.
  • Comparison of CFPNGS results with standard culture and PCR-based diagnostic techniques.

Main Results:

  • CFPNGS identified a pathogen in 86% (13/15) of pediatric CAP cases.
  • Standard methods alone detected pathogens in only 47% of cases.
  • Antibiotic management was adjusted in 47% (7/15) of children based on CFPNGS findings.

Conclusions:

  • CFPNGS offers a substantial improvement in pathogen detection for pediatric CAP compared to conventional methods.
  • This advanced sequencing technology can guide timely and appropriate antibiotic therapy adjustments.
  • CFPNGS represents a valuable tool for enhancing the diagnosis and management of severe pediatric CAP.

Keywords:
Cell-free plasma sequencingInfectious diseaseNGSPediatricPneumoniaPrecision medicine

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