Journal article
Pathogen-agnostic advanced molecular diagnostic testing for difficult-to-diagnose patients – results of an Emerging Infections Network survey of frontline U.S. Infectious Disease Clinicians, May 2023
Open forum infectious diseases, Vol.11(8), ofae395
07/30/2024
DOI: 10.1093/ofid/ofae395
PMCID: PMC11304606
PMID: 39113826
Abstract
Abstract During routine clinical practice, infectious disease physicians encounter patients with difficult-to-diagnose clinical syndromes and may order advanced molecular testing to detect pathogens. These tests may identify potential causes for illness and allow clinicians to adapt treatments or stop unnecessary antimicrobials. Cases of pathogen-agnostic disease testing also provide an important window into known, emerging and re-emerging pathogens and may be leveraged as part of national sentinel surveillance. A survey of Emerging Infections Network members, a group of infectious disease providers in North America, was conducted in May 2023. The objective of the survey was to gain insight into how and when infectious disease physicians use advanced molecular testing for patients with difficult-to-diagnose infectious diseases, as well as to explore the usefulness of advanced molecular testing and barriers to use. Overall, 643 providers answered at least some of the survey questions; 478 (74%) of those who completed the survey had ordered advanced molecular testing in the last two years and formed the basis for this study. Respondents indicated that they most often ordered broad-range 16s rRNA gene sequencing, followed by metagenomic next-generation sequencing and whole genome sequencing; and commented that in clinical practice some but not all tests were useful. Many physicians also noted several barriers to use, including a lack of national guidelines and cost, while others commented that whole genome sequencing had potential for use in outbreak surveillance. Improving frontline physician access, availability, affordability and developing clear national guidelines for interpretation and use of advanced molecular testing could potentially support clinical practice and public health surveillance.
Details
- Title: Subtitle
- Pathogen-agnostic advanced molecular diagnostic testing for difficult-to-diagnose patients – results of an Emerging Infections Network survey of frontline U.S. Infectious Disease Clinicians, May 2023
- Creators
- Preetika Rao - Centers for Disease Control and PreventionDiane L Downie - Centers for Disease Control and PreventionCorinne David-FerdonSusan E Beekmann - University of IowaScott Santibanez - National Center for Emerging and Zoonotic Infectious DiseasesPhilip M Polgreen - University of IowaMatthew Kuehnert - Centers for Disease Control and PreventionSean Courtney - Centers for Disease Control and PreventionJustin Lee - Centers for Disease Control and PreventionJasmine Chaitram - Centers for Disease Control and PreventionReynolds M Salerno - Centers for Disease Control and PreventionAdi V Gundlapalli - Centers for Disease Control and Prevention
- Resource Type
- Journal article
- Publication Details
- Open forum infectious diseases, Vol.11(8), ofae395
- DOI
- 10.1093/ofid/ofae395
- PMID
- 39113826
- PMCID
- PMC11304606
- NLM abbreviation
- Open Forum Infect Dis
- ISSN
- 2328-8957
- eISSN
- 2328-8957
- Publisher
- OXFORD UNIV PRESS INC
- Grant note
- Centers for Disease Control and Prevention: NU50CK000574
This work was supported by the Centers for Disease Control and Prevention Grant Number NU50CK000574 to the Infectious Diseases Society of America's Emerging Infections Network.
- Language
- English
- Electronic publication date
- 07/13/2024
- Date published
- 07/30/2024
- Academic Unit
- Infectious Diseases; Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984658255402771
Metrics
8 Record Views