Department of Medical Microbiology, PGIMER, Chandigarh, India.
Department of Medical Microbiology, AIMS, Mohali, India.
Indian J Med Microbiol. 2023 Nov-Dec;46:100433. doi: 10.1016/j.ijmmb.2023.100433. Epub 2023 Aug 9.
Detection of infectious diseases, especially among immunocompromised and patients on prolonged anti-microbial treatment, remains challenging, limited by conventional techniques with low sensitivity and long-turnaround time. Molecular detection by polymerase chain reaction (PCR) also has limited utility as it requires a targeted approach with prior suspicion of the infecting organism. Advancements in sequencing methodologies, specifically next-generation sequencing (NGS), have presented a promising opportunity to identify pathogens in cases where conventional techniques may be inadequate. However, the direct application of these techniques for diagnosing invasive infections is still limited by the need for invasive sampling, highlighting the pressing need to develop and implement non-invasive or minimally invasive approaches to improve the diagnosis of invasive infections.
The objectives of this article are to explore the notable features, clinical utility, and constraints associated with the detection of microbial circulating cell-free DNA (mcfDNA) as a minimally invasive diagnostic tool for infectious diseases.
The mcfDNA detection provides an opportunity to identify micro-organisms in the blood of a patient. It is especially beneficial in immunocompromised patients where invasive sampling is not possible or where repeated cultures are negative. This review will discuss the applications and constraints of detecting mcfDNA for diagnosing infections and the various platforms available for its detection.
传染病的检测,尤其是在免疫功能低下和接受长期抗菌治疗的患者中,仍然具有挑战性,这是因为传统技术的敏感性较低,且周转时间较长。聚合酶链反应(PCR)的分子检测也具有一定的局限性,因为它需要在怀疑感染病原体之前进行靶向检测。测序方法的进步,特别是下一代测序(NGS),为识别传统技术可能不足的病原体提供了一个有前途的机会。然而,这些技术直接应用于诊断侵袭性感染仍然受到需要侵袭性采样的限制,这突出表明迫切需要开发和实施非侵袭性或微创性方法来改善侵袭性感染的诊断。
本文的目的是探讨微生物游离循环 DNA(mcfDNA)检测作为一种微创诊断工具在传染病检测中的显著特征、临床应用和局限性。
mcfDNA 检测为患者血液中的微生物提供了一种识别机会。对于免疫功能低下的患者,特别是对于那些无法进行侵袭性采样或反复培养为阴性的患者,这尤其有益。本综述将讨论检测 mcfDNA 诊断感染的应用和局限性,以及用于检测 mcfDNA 的各种平台。