{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T02:32:28Z","timestamp":1785378748406,"version":"3.55.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T00:00:00Z","timestamp":1719964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Karius, Inc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This study characterizes the clinical utility and validity of the Karius test (KT), a plasma microbial cell-free DNA sequencing platform, as an infection surveillance tool among hematopoietic stem cell transplant (HCT) recipients, including monitoring for cytomegalovirus (CMV) and detecting infections relative to standard microbiologic testing (SMT).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A prospective, observational cohort study was performed among adult HCT recipients as inpatients and outpatients. Serial KTs were performed starting with 1 sample within 14 days before HCT, then weekly from 7\u201363 days posttransplant then monthly from 3\u201312 months post-HCT. Diagnostic performance of KT versus CMV polymerase chain reaction was evaluated with positive percent agreement and negative percent agreement. Infectious events (&amp;lt;12 months post-HCT) were extracted from medical records. For infectious events without positive SMT, 2 clinicians adjudicated KT results to determine if any detections were a probable cause. Difference in time from KT pathogen detection and infection onset was calculated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 70 participants, mean age was 49.9 years. For CMV surveillance, positive percent agreement was 100% and negative percent agreement was 90%. There was strong correlation between CMV DNA and KT molecules per microliter (r2: 0.84, P &amp;lt; .001). Of the 32 SMT+\/KT+ infectious events, KT identified 26 earlier than SMT (median: \u221212 days) and an additional 5 diagnostically difficult pathogens identified by KT but not SMT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>KT detected CMV with high accuracy and correlation with quantitative polymerase chain reaction. Among infectious events, KT demonstrated additive clinical utility by detecting pathogens earlier than SMT and those not detected by SMT.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofae330","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T19:31:57Z","timestamp":1719948717000},"source":"Crossref","is-referenced-by-count":6,"title":["Utility of Serial Microbial Cell-free DNA Sequencing for Inpatient and Outpatient Pathogen Surveillance Among Allogeneic Hematopoietic Stem Cell Transplant Recipients"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1725-5259","authenticated-orcid":false,"given":"Monica","family":"Fung","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, University of California San Francisco , San Francisco, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0921-549X","authenticated-orcid":false,"given":"Nimish","family":"Patel","sequence":"additional","affiliation":[{"name":"Skaggs School of Pharmacy & Pharmaceutical Sciences, University of California San Diego , La Jolla, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"DeVoe","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of California San Francisco , San Francisco, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin N","family":"Ryan","sequence":"additional","affiliation":[{"name":"Karius, Inc. , Redwood City, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Staci","family":"McAdams","sequence":"additional","affiliation":[{"name":"Karius, Inc. , Redwood City, California , 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