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Technology Diagnoses Pneumonia Caused by Undetected Pathogens

By LabMedica International staff writers
Posted on 11 Oct 2017
A novel next-generation sequencing (NGS) test for respiratory infections has been launched. The test provides a new solution for thousands of physicians who currently experience difficulty in diagnosing and treating patients with pneumonia and other respiratory diseases.

A strategic partnership was developed and commercialized novel infectious disease testing using metagenomics. This hypothesis-free approach to infectious disease testing uses DNA and RNA analysis to quickly identify bacteria, viruses, fungi, and parasites in patient samples.

Image: Digitally-colorized scanning electron micrograph (SEM) depicts a blue-colored, human white blood cell (WBC) known specifically as a neutrophil, interacting with two pink-colored, rod-shaped, multidrug-resistant (MDR) Klebsiella pneumoniae bacteria (Photo courtesy of the CDC).
Image: Digitally-colorized scanning electron micrograph (SEM) depicts a blue-colored, human white blood cell (WBC) known specifically as a neutrophil, interacting with two pink-colored, rod-shaped, multidrug-resistant (MDR) Klebsiella pneumoniae bacteria (Photo courtesy of the CDC).

The test detects more than 200 common and rare bacterial, fungal, and viral respiratory pathogens with a single test. By providing more comprehensive and actionable information within a clinically relevant turnaround time, this testing can help reduce inappropriate antibiotic use, avoid sequential testing, and potentially shorten hospital stays.

Diagnosing patients, particularly critically ill, immunocompromised patients, with suspected pneumonia can potentially require more than a dozen tests (including test panels) to determine the culprit pathogen. The novel test, known as Explify Respiratory, was developed by Arup Laboratories (Salt lake City, UT, USA) and IDbyDNA, Inc (San Francisco, CA, USA). The test is powered by IDbyDNA’s Taxonomer software, a DNA search engine that can rapidly identify any organism by its genetic material. In a study, Explify Respiratory identified pathogens missed by conventional laboratory tests in 44% of immunocompromised children treated in the intensive care unit (ICU) for pneumonia. In 67% of specimens, only one pathogen was detected. Pathogens included 13 bacteria; Klebsiella pneumoniae, Haemophilus influenzae, Staphylococcus aureus; seven fungi; Mucor spp., Fusarium spp., Pneumocystis jirovecii and viruses.

Robert Schlaberg, MD, Dr Med, MPH, a specialist in molecular infectious disease testing, said, “Current diagnostic techniques rely heavily on testing for suspected pathogens, which can be inconclusive and time-consuming. This technology can test for a very large number of pathogens at once, whether they are expected or not. A doctor doesn’t have to suspect the cause of a patient’s infection to direct the test ordering, but can instead simply ask, ‘What is my patient infected with?’” The study was originally presented at the 2017 American Thoracic Society Annual Meeting, held May 19-24, 2017, in Washington, DC, USA.

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