1887

Abstract

The commercial multi-pathogen probe-based real-time PCR SeptiFast (SF) was evaluated as a rapid and complementing tool for the microbiological diagnosis of bloodstream infections (BSIs) in a series of 138 matched blood samples from 65 patients with bacteraemia, hospitalized in an intensive care unit, when antibiotics had already been administered. SF was positive in 32.6 % of the samples, whereas blood culture (BC) was positive in 21.7 % ( < 0.05). SF identified more pathogens (11 versus 5; specificity, 90.7 %) and reduced the time of aetiological diagnosis, with a mean of 16.3 versus 55.4 h needed for BC ( < 0.05). SF enabled appropriate pathogen-oriented therapy in 72 % (36/50) of the BSI group of patients on the basis of epidemiological data. According to our data, the use of SF provided important added value to BC, in terms of earlier aetiological diagnosis of BSIs, enabling pathogen-oriented therapy in patients receiving empirical antibiotic treatment.

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2015-07-01
2019-09-15
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References

  1. Baron E.J., Scott J.D., Tompkins L.S.. ( 2005;). Prolonged incubation and extensive subculturing do not increase recovery of clinically significant microorganisms from standard automated blood cultures. Clin Infect Dis 41: 1677–1680 [CrossRef] [PubMed].
    [Google Scholar]
  2. Bauer M., Reinhart K.. ( 2010;). Molecular diagnostics of sepsis – where are we today?. Int J Med Microbiol 300: 411–413 [CrossRef] [PubMed].
    [Google Scholar]
  3. Bouza E., Sousa D., Muñoz P., Rodríguez-Créixems M., Fron C., Lechuz J.G.. ( 2004;). Bloodstream infections: a trial of the impact of different methods of reporting positive blood culture results. Clin Infect Dis 39: 1161–1169 [CrossRef] [PubMed].
    [Google Scholar]
  4. Casalta J.P., Gouriet F., Roux V., Thuny F., Habib G., Raoult D.. ( 2009;). Evaluation of the LightCycler SeptiFast test in the rapid etiologic diagnostic of infectious endocarditis. Eur J Clin Microbiol Infect Dis 28: 569–573 [CrossRef] [PubMed].
    [Google Scholar]
  5. Chang S.S., Hsieh W.H., Liu T.S., Lee S.H., Wang C.H., Chou H.C., Yeo Y.H., Tseng C.P., Lee C.C.. ( 2013;). Multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis – a systemic review and meta-analysis. PLoS One 8: e62323 [CrossRef] [PubMed].
    [Google Scholar]
  6. Dark P.M., Dean P., Warhurst G.. ( 2009;). Bench-to-bedside review: the promise of rapid infection diagnosis during sepsis using polymerase chain reaction-based pathogen detection. Crit Care 13: 217 [CrossRef] [PubMed].
    [Google Scholar]
  7. Dark P., Dunn G., Chadwick P., Young D., Bentley A., Carlson G., Warhurst G.. ( 2011;). The clinical diagnostic accuracy of rapid detection of healthcare-associated bloodstream infection in intensive care using multipathogen real-time PCR technology. BMJ Open 1: e000181 [CrossRef] [PubMed].
    [Google Scholar]
  8. Dellinger R.P., Levy M.M., Carlet J.M., Bion J., Parker M.M., Jaeschke R., Reinhart K., Angus D.C., Brun-Buisson C., other authors. ( 2008;). Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 36: 296–327 [CrossRef] [PubMed].
    [Google Scholar]
  9. Fenollar F., Raoult D.. ( 2007;). Molecular diagnosis of bloodstream infections caused by non-cultivable bacteria. Int J Antimicrob Agents 30: (Suppl. 1), 7–15 [CrossRef] [PubMed].
    [Google Scholar]
  10. Fernández-Cruz A., Marín M., Kestler M., Alcalá L., Rodriguez-Créixems M., Bouza E.. ( 2013;). The value of combining blood culture and SeptiFast data for predicting complicated bloodstream infections caused by Gram-positive bacteria or Candida species. J Clin Microbiol 51: 1130–1136 [CrossRef] [PubMed].
    [Google Scholar]
  11. Garnacho-Montero J., Garcia-Garmendia J.L., Barrero-Almodovar A., Jimenez-Jimenez F.J., Perez-Paredes C., Ortiz-Leyba C.. ( 2003;). Impact of adequate empirical antibiotic therapy on the outcome of patients admitted to the intensive care unit with sepsis. Crit Care Med 31: 2742–2751 [CrossRef] [PubMed].
    [Google Scholar]
  12. Glerant J.C., Hellmuth D., Schmit J.L., Ducroix J.P., Jounieaux V.. ( 1999;). Utility of blood cultures in community-acquired pneumonia requiring hospitalization: influence of antibiotic treatment before admission. Respir Med 93: 208–212 [CrossRef] [PubMed].
    [Google Scholar]
  13. Hall M.J., Williams S.N., DeFrances C.J., Golosinskiy A.. ( 2011;). Inpatient care for septicemia or sepsis: a challenge for patients and hospitals. NCHS Data Brief 62: 1–8 [PubMed].
    [Google Scholar]
  14. Herne V., Nelovkov A., Kütt M., Ivanova M.. ( 2013;). Diagnostic performance and therapeutic impact of LightCycler SeptiFast assay in patients with suspected sepsis. Eur J Microbiol Immunol (Bp) 3: 68–76 [CrossRef] [PubMed].
    [Google Scholar]
  15. Kirn T.J., Weinstein M.P.. ( 2013;). Update on blood cultures: how to obtain, process, report, and interpret. Clin Microbiol Infect 19: 513–520 [CrossRef] [PubMed].
    [Google Scholar]
  16. Lehmann L.E., Hunfeld K.P., Emrich T., Haberhausen G., Wissing H., Hoeft A., Stüber F.. ( 2008;). A multiplex real-time PCR assay for rapid detection and differentiation of 25 bacterial and fungal pathogens from whole blood samples. Med Microbiol Immunol (Berl) 197: 313–324 [CrossRef] [PubMed].
    [Google Scholar]
  17. Lehmann L.E., Hunfeld K.P., Steinbrucker M., Brade V., Book M., Seifert H., Bingold T., Hoeft A., Wissing H., Stüber F.. ( 2010;). Improved detection of blood stream pathogens by real-time PCR in severe sepsis. Intensive Care Med 36: 49–56 [CrossRef] [PubMed].
    [Google Scholar]
  18. Livermore D.M., Wain J.. ( 2013;). Revolutionising bacteriology to improve treatment outcomes and antibiotic stewardship. Infect Chemother 45: 1–10 [CrossRef] [PubMed].
    [Google Scholar]
  19. Lodes U., Bohmeier B., Lippert H., König B., Meyer F.. ( 2012;). PCR-based rapid sepsis diagnosis effectively guides clinical treatment in patients with new onset of SIRS. Langenbecks Arch Surg 397: 447–455 [CrossRef] [PubMed].
    [Google Scholar]
  20. Lucignano B., Ranno S., Liesenfeld O., Pizzorno B., Putignani L., Bernaschi P., Menichella D.. ( 2011;). Multiplex PCR allows rapid and accurate diagnosis of bloodstream infections in newborns and children with suspected sepsis. J Clin Microbiol 49: 2252–2258 [CrossRef] [PubMed].
    [Google Scholar]
  21. Mancini N., Clerici D., Diotti R., Perotti M., Ghidoli N., De Marco D., Pizzorno B., Emrich T., Burioni R., other authors. ( 2008;). Molecular diagnosis of sepsis in neutropenic patients with haematological malignancies. J Med Microbiol 57: 601–604 [CrossRef] [PubMed].
    [Google Scholar]
  22. Mancini N., Carletti S., Ghidoli N., Cichero P., Burioni R., Clementi M.. ( 2010;). The era of molecular and other non-culture-based methods in diagnosis of sepsis. Clin Microbiol Rev 23: 235–251 [CrossRef] [PubMed].
    [Google Scholar]
  23. Paolucci M., Stanzani M., Melchionda F., Tolomelli G., Castellani G., Landini M.P., Varani S., Lewis R.E., Sambri V.. ( 2013;). Routine use of a real-time polymerase chain reaction method for detection of bloodstream infections in neutropaenic patients. Diagn Microbiol Infect Dis 75: 130–134 [CrossRef] [PubMed].
    [Google Scholar]
  24. Pasqualini L., Mencacci A., Leli C., Montagna P., Cardaccia A., Cenci E., Montecarlo I., Pirro M., di Filippo F., other authors. ( 2012;). Diagnostic performance of a multiple real-time PCR assay in patients with suspected sepsis hospitalized in an internal medicine ward. J Clin Microbiol 50: 1285–1288 [CrossRef] [PubMed].
    [Google Scholar]
  25. Peters R.P., van Agtmael M.A., Danner S.A., Savelkoul P.H., Vandenbroucke-Grauls C.M.. ( 2004;). New developments in the diagnosis of bloodstream infections. Lancet Infect Dis 4: 751–760 [CrossRef] [PubMed].
    [Google Scholar]
  26. Pletz M.W., Wellinghausen N., Welte T.. ( 2011;). Will polymerase chain reaction (PCR)-based diagnostics improve outcome in septic patients? A clinical view. Intensive Care Med 37: 1069–1076 [CrossRef] [PubMed].
    [Google Scholar]
  27. Schaub N., Boldanova T., Noveanu M., Arenja N., Hermann H., Twerenbold R., Frei R., Bingisser R., Trampuz A., Mueller C.. ( 2014;). Incremental value of multiplex real-time PCR for the early diagnosis of sepsis in the emergency department. Swiss Med Wkly 144: w13911 [PubMed].
    [Google Scholar]
  28. Sharma S., Kumar A.. ( 2008;). Antimicrobial management of sepsis and septic shock. Clin Chest Med 29: 677–687 [CrossRef] [PubMed].
    [Google Scholar]
  29. Weinstein M.P.. ( 2003;). Blood culture contamination: persisting problems and partial progress. J Clin Microbiol 41: 2275–2278 [CrossRef] [PubMed].
    [Google Scholar]
  30. Zubert S., Funk D.J., Kumar A.. ( 2010;). Antibiotics in sepsis and septic shock: like everything else in life, timing is everything. Crit Care Med 38: 1211–1212 [CrossRef] [PubMed].
    [Google Scholar]
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