Daily Fungal Cell-Free DNA Testing to Assess Clinical Status during Candida krusei Fungemia

• Published in: Journal of fungi (Basel) Vol. 10; no. 7; p. 449
• Main Authors: Young, Jo-Anne H, Liu, Xiaoying, Porter, Emma, Sweet, Hannah, Wang, Wei, Evans, Anton F, Zhang, Chi, Obeid, Karam M
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.07.2024
• Subjects: Abdomen; Automation; Biopsy; Biosensors; Blood; Candida krusei; Care and treatment; cell-free DNA; cfDNA; Chemotherapy; Control systems; DNA; Ethylenediaminetetraacetic acid; Fungal infections; Fungemia; Fungi; giant magnetoresistance (GMR); Health aspects; Immune system; Infection; Infection control; Myelodysplastic syndrome; Neutropenia; Plasma; point of care (POC); Posaconazole; Review boards; Sensors; Skin; Skin diseases; Skin lesions; Skin tests; United States > US
• ISSN: 2309-608X; 2309-608X
• DOI: 10.3390/jof10070449

We present a case of a man immunocompromised due to myelodysplastic syndrome with Candida krusei fungemia who had a rising cell-free DNA (cfDNA) giant magnetoresistance (GMR) signal when tested daily using plasma blood samples. With the rise in GMR signal paralleling the development of skin lesions in this patient, we conclude that cfDNA can be used to indicate uncontrolled infection and thus help monitor response to therapy. This index patient provides evidence that an invasive fungal infection requires both direct antifungal therapy and an intact immune system to control the infection. This biosensing platform has been simplified to potentially serve as a point-of-care test, setting it apart by overcoming the three common barriers of cfDNA testing: complexity, cost, and time.