Clinical impact of a commercially available multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis

Dierkes, Christine and Ehrenstein, Boris and Siebig, Sylvia and Linde, Hans-Joerg and Reischl, Udo and Salzberger, Bernd (2009) Clinical impact of a commercially available multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis. BMC INFECTIOUS DISEASES, 9: 126. ISSN 1471-2334,

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Abstract

Background: Timely identification of pathogens is crucial to minimize mortality in patients with severe infections. Detection of bacterial and fungal pathogens in blood by nucleic acid amplification promises to yield results faster than blood cultures (BC). We analyzed the clinical impact of a commercially available multiplex PCR system in patients with suspected sepsis. Methods: Blood samples from patients with presumed sepsis were cultured with the Bactec 9240 (TM) system (Becton Dickinson, Heidelberg, Germany) and aliquots subjected to analysis with the LightCycler (R) SeptiFast (R) (SF) Test (Roche Diagnostics, Mannheim, Germany) at a tertiary care centre. For samples with PCR-detected pathogens, the actual impact on clinical management was determined by chart review. Furthermore a comparison between the time to a positive blood culture result and the SF result, based on a fictive assumption that it was done either on a once or twice daily basis, was made. Results: Of 101 blood samples from 77 patients, 63 (62%) yielded concordant negative results, 14 (13%) concordant positive and 9 (9%) were BC positive only. In 14 (13%) samples pathogens were detected by SF only, resulting in adjustment of antibiotic therapy in 5 patients (7,7% of patients). In 3 samples a treatment adjustment would have been made earlier resulting in a total of 8 adjustments in all 101 samples (8%). Conclusion: The addition of multiplex PCR to conventional blood cultures had a relevant impact on clinical management for a subset of patients with presumed sepsis.

Item Type: Article
Uncontrolled Keywords: BLOOD-STREAM INFECTIONS; ANTIMICROBIAL THERAPY; SEPTIC SHOCK; SURVEILLANCE; BACTEREMIA; FUNGEMIA; ICU;
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Innere Medizin I
Medicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene
Depositing User: Dr. Gernot Deinzer
Date Deposited: 09 Sep 2020 09:46
Last Modified: 09 Sep 2020 09:46
URI: https://pred.uni-regensburg.de/id/eprint/28571

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