Could cell‐free DNA and host biomarkers assist in antimicrobial stewardship with organ transplant recipients?

Background Antimicrobial stewardship in solid organ transplant (SOT) recipients is important to prevent antimicrobial‐associated complications, but traditional stewardship principles are challenging to implement for SOT patients. Newer methodologies to optimize stewardship efforts are needed. Method...

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Bibliographic Details
Published in:Transplant infectious disease 2022-10, Vol.24 (5), p.e13971-n/a
Main Authors: Chang, Sandy Y., Santos, Carlos A. Q.
Format: Article
Language:English
Subjects:
Antiinfectives and antibacterials
Antimicrobial agents
antimicrobial stewardship
Biomarkers
cell‐free DNA
Complications
Deoxyribonucleic acid
DNA
DNA sequencing
Gene expression
gene expression profiling
Immunocompromised hosts
Metagenomics
Microorganisms
solid organ transplant
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Summary:Background Antimicrobial stewardship in solid organ transplant (SOT) recipients is important to prevent antimicrobial‐associated complications, but traditional stewardship principles are challenging to implement for SOT patients. Newer methodologies to optimize stewardship efforts are needed. Methods PubMed was searched using the keywords “cell free DNA,” “metagenomic sequencing,” “host biomarker,” “antimicrobial stewardship,” and “SOT.” Results Metagenomic sequencing of cell free DNA has the potential to be a stewardship tool for SOT recipients. Various studies have shown its use for antimicrobial de‐escalation and duration shortening. Host gene expression profiles can differentiate between infectious and noninfectious syndromes and may assist in stewardship efforts. However, information in immunocompromised hosts is conflicting. Conclusion Microbial cell free DNA sequencing and host gene expression profiling show promise as stewardship tools in SOT recipients. Future studies on antimicrobial stewardship in SOT recipients should focus on their clinical use and feasibility.
ISSN:1398-2273
1399-3062
DOI:10.1111/tid.13971