Time course of patient S9. An 82-year-old male patient presented with a tumor of his bile duct with the need for an enlarged right-sided hemihepatectomy. Following the surgical procedure, the patient suffered from septic shock due to Ogilvie syndrome and a right-sided hemicolectomie had to be performed. Septic shock was paralleled by repetitive positive blood cultures with Enterobacter cloacae, which was shown to be the cause of ventilator-associated pneumonia 1Â week after sepsis onset. Following antibiotic treatment, two different biotypes of E. cloacae could be observed, both fulfilling the criteria of being multidrug resistant. The patient died 9Â weeks after the onset of septic shock. In this figure, the antibiotic treatment regime, SIQ scores for species identified via NGS, and cfDNA concentrations of the respective plasma samples are plotted over the timeline of the trial period for patient S9. Pertinent clinical microbiology laboratory results are marked using arrows to indicate the day the clinical specimen was obtained. Abbreviations: BC blood culture, CVC central venous catheter, TS tracheal secretion, NL non-lysing, CIP ciproflocaxine, MTZ metronidazole, IPM imipenem, LZD linezolid, FLC fluconazole, VAN vancomycin. Anti-infectives are displayed as antibacterial antibiotics, antimycotics, and antivirals in light grey, black, and dark grey, respectively. The relative amount of bacteria found by conventional clinical microbiology is indicated with plenty (p), medium (m), or scarce (s). (For a detailed list of the anti-infective abbreviations, see Additional file 9: Table S5.) (PDF 16 kb)