{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:54:54Z","timestamp":1790031294988,"version":"4.0.1"},"reference-count":138,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"vor","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Karius, Inc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Improved diagnostic testing (DT) of infections may optimize outcomes for solid organ transplant recipients (SOTR), but a comprehensive analysis is lacking.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a systematic literature review across multiple databases, including EMBASE and MEDLINE(R), of studies published between 1 January 2012\u201311 June 2022, to examine the evidence behind DT in SOTR. Eligibility criteria included the use of conventional diagnostic methods (culture, biomarkers, directed-polymerase chain reaction [PCR]) or advanced molecular diagnostics (broad-range PCR, metagenomics) to diagnose infections in hospitalized SOTR. Bias was assessed using tools such as the Cochrane Handbook and PRISMA 2020.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 2362 studies, 72 were eligible and evaluated heterogeneous SOT populations, infections, biospecimens, DT, and outcomes. All studies exhibited bias, mainly in reporting quality. Median study sample size was 102 (range, 11\u20131307). Culture was the most common DT studied (N = 45 studies, 62.5%), with positive results in a median of 27.7% (range, 0%\u201388.3%). Biomarkers, PCR, and metagenomics were evaluated in 7, 19, and 3 studies, respectively; only 6 reported sensitivity, specificity, and positive\/negative predictive values. Directed-PCR performed well for targeted pathogens, but only 1 study evaluated broad-range PCR. Metagenomics approaches detected numerous organisms but required clinical adjudication, with too few studies (N = 3) to draw conclusions. Turnaround time was shorter for PCR\/metagenomics than conventional diagnostic methods (N = 4 studies, 5.6%). Only 6 studies reported the impact of DT on outcomes like antimicrobial use and length of stay.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We identified considerable evidence gaps in infection-related DT among SOT, particularly molecular DT, highlighting the need for further research.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf001","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T18:28:23Z","timestamp":1736360903000},"source":"Crossref","is-referenced-by-count":3,"title":["A Systematic Literature Review to Determine Gaps in Diagnosing Suspected Infection in Solid Organ Transplant Recipients"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5997-2723","authenticated-orcid":false,"given":"Sarah Y","family":"Park","sequence":"first","affiliation":[{"name":"Medical Affairs, Karius, Inc. , Redwood City, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3825-6832","authenticated-orcid":false,"given":"Jason D","family":"Goldman","sequence":"additional","affiliation":[{"name":"Swedish Center for Research and Innovation, Providence Swedish Medical Center , Seattle, Washington ,","place":["USA"]},{"name":"Division of Allergy and Infectious Diseases, University of Washington , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2021-2233","authenticated-orcid":false,"given":"Deborah J","family":"Levine","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary, Critical Care and Allergy, Stanford University , Palo Alto, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0634-8211","authenticated-orcid":false,"given":"Ghady","family":"Haidar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, University of Pittsburgh and UPMC , Pittsburgh, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,1,8]]},"reference":[{"key":"2025012904162279600_ofaf001-B1","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1111\/ajt.14208","article-title":"Infection in organ transplantation","volume":"17","author":"Fishman","year":"2017","journal-title":"Am J Transplant"},{"key":"2025012904162279600_ofaf001-B2","doi-asserted-by":"publisher","first-page":"3440","DOI":"10.1016\/B978-1-4557-4801-3.00313-1","volume-title":"Mandell, Douglas, and Bennett's principles and practice of infectious 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