The Karius Diagnostic Test: A Missing Puzzle Piece

Billions upon billions of microbial organisms inhabit the earth and our bodies. When we get sick because of modern-day medicine and technology developments, we can often pinpoint exactly which microbial organisms are the source of the problem. But how, exactly? Karius Chief Technical Officer Sivan Bercovici and Medical Director Dr. Sarah Park joined host David Kemp to talk about the Karius diagnostic test and how it breaks barriers in antimicrobial research.

Karius surfaced out of transplantation research at Stanford, where researchers learned DNA from microbes is sent to the bloodstream and can then be harvested and analyzed. This analysis has two aspects: chemistry, which is capturing as many molecules as possible, and machine learning, which makes sense of the data.

“We all have microbes, and we have mixtures of microbes. And what’s making very hard is that this mixture of microbes or cell-free DNA coming from these microbes, can be similar to one another, they can be similar to other things,” explained Bercovici. “Machine learning had to kick into de-convolute that signal to tell you exactly which microbes you have and exactly what concentration of those microbes,” he continued. Bercovici added, “Unless you apply these algorithms, you end up with a pile of pieces of DNA that are impenetrable for any physician.”

The immunocompromised population is just one example of why diagnostic tests are necessary. With this population, they could have multiple infections due to a lack of immunity. “As a clinician, you really have to think about ‘What test do I order?’” Dr. Park explained. This can be difficult with insurance, which may not agree to cover a test a physician deems necessary, and physicians often end up ordering multiple tests.

“This is where tests like the Karius test can be very useful in conjunction with your other tests to be able to add potentially the answer to the question you’re asking, which is: “What is causing the problem for my patient?’” Dr. Park stated.

With the Karius test, the earlier you use it, the better the results will be, but the results still need to be interpreted in the context of each patient. The test result is not meaningful until put in the context of the patient—what medications they are on, their potential exposures, and other factors. The same microbe detected in patient A will not have the same effect in patient B if their clinical status is different.

“It’s like looking at pieces of a puzzle, and some of the pieces are together, and without the Karius test, we are still missing a huge part of the picture. And hopefully what the Karius test does is fill in more of that picture and make that picture more meaningful so that the clinician can actually use the appropriate antimicrobials, know how to manage the patient better, potentially have that chance to save the patient,” Dr. Park explained.

For more on the Karius diagnostic test and its impact on antimicrobial research and clinical use, visit Spotify, Apple iTunes, YouTube, or

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