Summary: The Karius Test, a genomic diagnostic tool for lung infections in immunocompromised patients, received Breakthrough Device Designation from the FDA, promising expedited development and review of the test.


  1. The Karius Test specializes in detecting lung infections like pneumonia in immunocompromised individuals, addressing an urgent need for improved diagnostics in this vulnerable group.
  2. Clinical studies show that the Karius Test increases the detection rate of infectious causes of pneumonia, providing more accurate and sensitive diagnostic outcomes.
  3. The FDA’s Breakthrough Device Designation for the Karius Test underscores its potential to significantly advance the treatment and management of life-threatening infections in immunocompromised patients.

Karius, a provider in genomic diagnostics for infectious diseases, announced that the Karius Test has been granted designation as a Breakthrough Device from The Center for Devices and Radiological Health (CDRH) of the US Food and Drug Administration (FDA), for use in the diagnosis and management of immunocompromised patients with suspected lung infections including lower respiratory infection and pneumonia.

“The Karius Test is commercially available nationwide as a laboratory developed test. We are seeking FDA marketing authorization of the Karius Test for lung infections in immunocompromised patients because improved diagnostic tests are urgently needed for these patients,” says Brad Perkins, MD, Chief Medical Officer of Karius. “As noted in the American Thoracic Society (ATS) Workshop Report for Immunocompromised Host Pneumonia: Definitions and Diagnostic Criteria,(1) lung infections have high morbidity and mortality in immunocompromised patients, which is why advances in technologies like metagenomic sequencing used for the Karius Test are vital in improving the diagnosis and treatment of these patients.”

FDA’s Breakthrough Device Designation

The Breakthrough Devices Program is a voluntary program for certain medical devices and device-led combination products that provide for more effective treatment or diagnosis of a life-threatening or irreversibly debilitating disease or condition. This program is designed to expedite the development and review of these innovative medical devices.

Pneumonia Diagnosis

Clinical data that support the use of the Karius Test in pneumonia for immunocompromised patients includes the results of the PICKUP study, where results showed that the Karius Test increased the relative yield for detection of a probable cause for pneumonia by 40%.(2) Additionally, the Karius Test identified clinically relevant non-pneumonia infections in 39% of subjects.(2) These additional data highlight the ATS Workshop Report observation that “the existing clinical definition of pneumonia is syndromic and lacks specificity,” (1) and support the value of approaches that are agnostic to both the pathogen and the site of infection like the Karius Test.

Further reading: Karius Liquid Biopsy Becomes Diagnostic Recommendation for Infective Endocarditis

“Recent data from several trials indicate that the Karius Test offers a speedy, accurate, and sensitive diagnosis of infectious causes of pneumonia and related infections in immunocompromised patients. As such, it represents a major advance in the care of patients with hematologic cancers and those undergoing stem cell transplantation,” says Norman E. Sharpless, MD; former Director of the National Cancer Institute and Acting Commissioner of the Food and Drug Administration, and member of the Karius board.

New data from the PICKUP study on the cost-effectiveness of the Karius Test will be presented at the American Thoracic Society Annual Meeting 2024 International Conference.


  1. Cheng et al, Annals of the American Thoracic Society, 2023
  2. Bergin SP, et al. Clinical Infectious Diseases. October 2023