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Metagenomics in pediatrics: using a shotgun approach to diagnose infections

Bender, Jeffrey, M.a,b; Dien Bard, Jenniferb,c

doi: 10.1097/MOP.0000000000000577
INFECTIOUS DISEASES AND IMMUNIZATION: Edited by Yvonne J. Bryson

Purpose of review With the advent of novel massively parallel sequencing technologies and bioinformatic processing capabilities, clinical applications of metagenomic studies are rapidly being integrated into medicine. Through this paper, we hope to introduce this powerful new tool to clinicians caring for children.

Recent findings Very few studies have looked at metagenomic applications in children. The ability to perform these types of massive sequencing projects was not possible as little as 7 years ago.

Summary Metagenomics is defined as the study of all genetic material within a given sample. Novel sequencing and analysis approaches allow for unbiased assays to identify pathogens missed by targeted sequencing and culture methods. Although not widely available yet, metagenomic studies have been used to diagnose pediatric infections, identify resistance genes in clinical samples, and characterize outbreaks. Although cost and turnaround time have limited its application in clinical laboratories to date, novel platforms and increasing comfort with these techniques continue to push diagnostic metagenomics into clinical pediatric medicine. Much work in this field is yet to be done. That being said, we feel that pediatric clinicians will be using metagenomic techniques in the care of children with increasing frequency in the near future.

aDivision of Infectious Diseases, Department of Pediatrics, Children's Hospital Los Angeles

bKeck School of Medicine at the University of Southern California

cDepartment of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA

Correspondence to Jennifer Dien Bard, PhD D(ABMM), Keck School of Medicine at the University of Southern California, 4650 Sunset Blvd. MS#32, Los Angeles, CA 90027, USA. E-mail: jdienbard@chla.usc.edu

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