{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T03:23:43Z","timestamp":1792121023656,"version":"4.4.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T00:00:00Z","timestamp":1714694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>An early diagnosis and treatment of invasive fungal disease (IFD) is associated with improved outcome, but the moderate sensitivity of noninvasive diagnostic tests makes this challenging. Invasive diagnostic procedures such as bronchoalveolar lavage (BAL) have a higher yield but are not without risk. The detection and sequencing of microbial cell-free DNA (mcfDNA) may facilitate a noninvasive diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials<\/jats:title>\n                    <jats:p>In a prospective observational study, we collected plasma in the 120\u2005hours preceding or following a BAL in patients with hematological malignancies suspected for a pulmonary IFD. The EORTC\/MSGERC2020 criteria were used for IFD classification. Sequencing was performed by Karius (Redwood City, CA) using their Karius Test (KT) on plasma and a \u201cresearch use only test\u201d on BAL fluid if available. Cases with a probable\/proven IFD were identified based on standard diagnostic tests on serum and BAL (microscopy, polymerase chain reaction, galactomannan, culture) and used to calculate the sensitivity, specificity, and additional diagnostic value of the KT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 106 patients enrolled, 39 (37%) had a proven\/probable invasive aspergillosis, 7 (7%) a non-Aspergillus IFD, and 4 (4%) a mixed IFD. The KT detected fungal mcfDNA in 29 (28%) patients. Compared with usual diagnostic tests, the sensitivity and specificity were 44.0% (95% confidence interval [CI], 31.2\u201357.7) and 96.6% (95% CI, 88.5%\u201399.1%). Sensitivity of the KT was higher in non-Aspergillus IFD (Mucorales:2\/3, Pneumocystis jirovecii: 3\/5). On BAL, the sensitivity was 72.2% (95% CI, 62.1\u201396.3), and specificity 83.3% (95% CI, 49.1\u201387.5).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sequencing of mcfDNA may facilitate a noninvasive diagnosis of IFD in particular non-Aspergillus IFD. However, on plasma and similar to currently available diagnostics, it cannot be used as a \u201crule-out\u201d test.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofae252","type":"journal-article","created":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T07:55:03Z","timestamp":1714550103000},"source":"Crossref","is-referenced-by-count":39,"title":["Diagnostic Value of Microbial Cell-free DNA Sequencing for Suspected Invasive Fungal Infections: A Retrospective Multicenter Cohort Study"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9418-8256","authenticated-orcid":false,"given":"Sammy","family":"Huygens","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Section of Infectious Diseases and Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center , Rotterdam , The Netherlands"},{"name":"Department of Hematology, Ghent University Hospital , Ghent , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3224-3969","authenticated-orcid":false,"given":"Alexander","family":"Schauwvlieghe","sequence":"additional","affiliation":[{"name":"Department of Hematology, AZ St-Jan Brugge-Oostende Hospital , Bruges , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2512-4600","authenticated-orcid":false,"given":"Nick","family":"Wlazlo","sequence":"additional","affiliation":[{"name":"Department of Hematology, Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3079-8909","authenticated-orcid":false,"given":"Ine","family":"Moors","sequence":"additional","affiliation":[{"name":"Department of Hematology, Ghent University Hospital , Ghent , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2282-8194","authenticated-orcid":false,"given":"Jerina","family":"Boelens","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Ghent University Hospital , Ghent , Belgium"},{"name":"Department of Diagnostic Sciences, Ghent University , Ghent , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2079-1279","authenticated-orcid":false,"given":"Marijke","family":"Reynders","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Medical Microbiology, AZ St-Jan Brugge-Oostende Hospital , Bruges , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6535-2213","authenticated-orcid":false,"given":"Ga-Lai","family":"Chong","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology & Infectious Diseases, Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3439-0903","authenticated-orcid":false,"given":"Corn\u00e9 H W","family":"Klaassen","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology & Infectious Diseases, Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3343-9610","authenticated-orcid":false,"given":"Bart J A","family":"Rijnders","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Infectious Diseases and Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center , Rotterdam , The 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