Use of Advanced Diagnostics for Timely Identification of Travel-associated Leptospira santarosai Infection in Four Adolescents Through Plasma Microbial Cell-free DNA Sequencing With the Karius Test

Authors

• Hai Nguyen-Tran
• Guliz Erdem
• P Marcelo Laufer
• Lori Patterson
• Asim A Ahmed
• William A Bower
• Renee Galloway
• Sara Saporta-Keating

Language

English

Publication Date

5-1-2024

Journal

The Pediatric Infectious Disease Journal

DOI

10.1097/INF.0000000000004255

PMID

38241644

PMCID

PMC11884335

PubMedCentral® Posted Date

3-6-2026

PubMedCentral® Full Text Version

Author MSS

Abstract

Background: Leptospirosis is an important zoonotic infection worldwide. Diagnosis of leptospirosis is challenging given its nonspecific clinical symptoms that overlap with other acute febrile illnesses and limitations with conventional diagnostic testing. Alternative advanced diagnostics, such as microbial cell-free DNA (mcfDNA), are increasingly being used to aid in the diagnosis of infections and can be applied to pathogens with public health importance such as Leptospira , a nationally notifiable disease.

Methods: The Karius Test uses plasma mcfDNA sequencing to detect and quantify DNA-based pathogens. This test offered through the Karius lab detected 4 cases of Leptospira santarosai during a 5-month period across the United States in 2021 and were clinically reviewed.

Results: In our case series, 4 adolescents with recent travel to Central America (Costa Rica, n = 3 and Belize, n = 1) from April to August 2021 were diagnosed with leptospirosis. While a large workup was performed in all cases, mcfDNA testing was the first test to detect L. santarosai as the microbiological diagnosis in all cases.

Conclusions: Results of the Karius Test enabled rapid, noninvasive diagnosis of leptospirosis allowing for targeted therapy. Use of mcfDNA can be utilized for diagnosis of pathogens where conventional testing is challenging or limited. This in turn can enable quick diagnosis for targeted treatment and potentially aid in supporting case definitions of reportable diseases of public health concern.

Keywords

Humans, Adolescent, Travel, Leptospira, Leptospirosis, Cell-Free Nucleic Acids, Sequence Analysis, DNA

Published Open-Access

yes

Recommended Citation

Nguyen-Tran, Hai; Erdem, Guliz; Laufer, P Marcelo; et al., "Use of Advanced Diagnostics for Timely Identification of Travel-associated Leptospira santarosai Infection in Four Adolescents Through Plasma Microbial Cell-free DNA Sequencing With the Karius Test" (2024). Faculty, Staff and Student Publications. 4153.
https://digitalcommons.library.tmc.edu/uthmed_docs/4153