Skip to main content
Erschienen in: Wiener klinische Wochenschrift 7-8/2012

01.04.2012 | short report

Rapid detection of bloodstream pathogens by real-time PCR in patients with sepsis

verfasst von: Katharina Grif, Manfred Fille, Reinhard Würzner, Günter Weiss, Ingo Lorenz, Gottfried Gruber, Stephan Eschertzhuber, David Nachbaur, Cornelia Lass-Flörl, Dorothea Orth

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 7-8/2012

Einloggen, um Zugang zu erhalten

Summary

Rapid detection of bloodstream infections is an important issue for a better patient outcome. The aim of our study was thus to evaluate the LightCycler SeptiFast assay for diagnosis of bloodstream pathogens in a tertiary hospital in Western Austria. The 71 blood samples of 61 patients with presumed sepsis were investigated and compared with conventional blood culture system results. In both assays, 51 samples (71.8 %) were negative. In 20 positive samples (28.2 %), 10 different pathogens were detected by either blood culture system or SeptiFast assay or by both methods. Five samples were positive in both assays. The agreement rate of blood culture system and SeptiFast assay was 78.9 %, the negative predictive value of SeptiFast assay versus blood culture system was 0.94, sensitivity was 0.63, and specificity 0.81. In 12 samples where a positive SeptiFast assay and a negative blood culture system result were obtained, the same pathogens as identified by SeptiFast assay were detected in samples from other body sites suggesting a correct positive detection. In 11.3 % of cases, the SeptiFast assay resulted in an adjustment of the patients’ therapy. In 3 samples, the blood culture assay was positive whereas the SeptiFast assay yielded negative results. In two of these cases, the pathogens involved were not included in the SeptiFast detection list, in the third case SeptiFast assay failed to detect Candida glabrata.
Thus we recommend the SeptiFast assay as a valuable tool for rapid diagnosis of bloodstream infections in addition to, but not as replacement for, the blood culture test.
Literatur
1.
Zurück zum Zitat Beekmann SE, Diekema DJ, Chapin KC, Doern GV. Effects of rapid detection of bloodstream infections on length of hospitalization and hospital charges. J Clin Microbiol. 2003;41(7):3119–25.PubMedCrossRef Beekmann SE, Diekema DJ, Chapin KC, Doern GV. Effects of rapid detection of bloodstream infections on length of hospitalization and hospital charges. J Clin Microbiol. 2003;41(7):3119–25.PubMedCrossRef
2.
Zurück zum Zitat Struelens MJ. Detection of microbial DNAemia: does it matter for sepsis management? Intensive Care Med. 2010;36(2):193–5.PubMedCrossRef Struelens MJ. Detection of microbial DNAemia: does it matter for sepsis management? Intensive Care Med. 2010;36(2):193–5.PubMedCrossRef
3.
Zurück zum Zitat Peters RP, van Agtmael MA, Danner SA, Savelkoul PH, Vandenbroucke-Grauls CM. New developments in the diagnosis of bloodstream infections. Lancet Infect Dis. 2004;4(12):751–60.PubMedCrossRef Peters RP, van Agtmael MA, Danner SA, Savelkoul PH, Vandenbroucke-Grauls CM. New developments in the diagnosis of bloodstream infections. Lancet Infect Dis. 2004;4(12):751–60.PubMedCrossRef
4.
Zurück zum Zitat Casalta JP, Gouriet F, Roux V, Thuny F, Habib G, Raoult D. Evaluation of the LightCycler SeptiFast test in the rapid etiologic diagnostic of infectious endocarditis. Eur J Clin Microbiol Infect Dis. 2009;28(6):569–73.PubMedCrossRef Casalta JP, Gouriet F, Roux V, Thuny F, Habib G, Raoult D. Evaluation of the LightCycler SeptiFast test in the rapid etiologic diagnostic of infectious endocarditis. Eur J Clin Microbiol Infect Dis. 2009;28(6):569–73.PubMedCrossRef
5.
Zurück zum Zitat Lehmann LE, Hunfeld KP, Emrich T, et al. A multiplex real-time PCR assay for rapid detection and differentiation of 25 bacterial and fungal pathogens from whole blood samples. Med Microbiol Immun. 2008;197(3):313–24.CrossRef Lehmann LE, Hunfeld KP, Emrich T, et al. A multiplex real-time PCR assay for rapid detection and differentiation of 25 bacterial and fungal pathogens from whole blood samples. Med Microbiol Immun. 2008;197(3):313–24.CrossRef
6.
Zurück zum Zitat Varani S, Stanzani M, Paolucci M, et al. Diagnosis of bloodstream infections in immunocompromised patients by real-time PCR. J Infect. 2009;58(5):346–51.PubMedCrossRef Varani S, Stanzani M, Paolucci M, et al. Diagnosis of bloodstream infections in immunocompromised patients by real-time PCR. J Infect. 2009;58(5):346–51.PubMedCrossRef
7.
Zurück zum Zitat Lucignano B, Ranno S, Liesenfeld O, et al. Multiplex PCR allows rapid and accurate diagnosis of bloodstream infections in newborns and children with suspected sepsis. J Clin Microbiol. 2011;49(6):2252–8.PubMedCrossRef Lucignano B, Ranno S, Liesenfeld O, et al. Multiplex PCR allows rapid and accurate diagnosis of bloodstream infections in newborns and children with suspected sepsis. J Clin Microbiol. 2011;49(6):2252–8.PubMedCrossRef
8.
Zurück zum Zitat Mencacci A, Leli C, Cardaccia A, Montagna P, et al. Comparison of conventional culture with SeptiFast real-time PCR for microbial pathogen detection in clinical specimens other than blood. J Med Microbiol. 2011;60:1774–8.PubMedCrossRef Mencacci A, Leli C, Cardaccia A, Montagna P, et al. Comparison of conventional culture with SeptiFast real-time PCR for microbial pathogen detection in clinical specimens other than blood. J Med Microbiol. 2011;60:1774–8.PubMedCrossRef
9.
Zurück zum Zitat Maubon D, Hamidfar-Roy R, Courby S, et al. Therapeutic impact and diagnostic performance of multiplex PCR in patients with malignancies and suspected sepsis. J Infect. 2010;61(4):335–42.PubMedCrossRef Maubon D, Hamidfar-Roy R, Courby S, et al. Therapeutic impact and diagnostic performance of multiplex PCR in patients with malignancies and suspected sepsis. J Infect. 2010;61(4):335–42.PubMedCrossRef
10.
Zurück zum Zitat Wallet F, Nseir S, Baumann L, et al. Preliminary clinical study using a multiplex real-time PCR test for the detection of bacterial and fungal DNA directly in blood. Clin Microbiol Infect. 2010;16(6):774–9.PubMedCrossRef Wallet F, Nseir S, Baumann L, et al. Preliminary clinical study using a multiplex real-time PCR test for the detection of bacterial and fungal DNA directly in blood. Clin Microbiol Infect. 2010;16(6):774–9.PubMedCrossRef
11.
Zurück zum Zitat Ibrahim EH, Sherman G, Ward S, Fraser VJ, Kollef MH. The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest. 2000;118(1):146–55.PubMedCrossRef Ibrahim EH, Sherman G, Ward S, Fraser VJ, Kollef MH. The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest. 2000;118(1):146–55.PubMedCrossRef
Metadaten
Titel
Rapid detection of bloodstream pathogens by real-time PCR in patients with sepsis
verfasst von
Katharina Grif
Manfred Fille
Reinhard Würzner
Günter Weiss
Ingo Lorenz
Gottfried Gruber
Stephan Eschertzhuber
David Nachbaur
Cornelia Lass-Flörl
Dorothea Orth
Publikationsdatum
01.04.2012
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 7-8/2012
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-012-0159-4

Weitere Artikel der Ausgabe 7-8/2012

Wiener klinische Wochenschrift 7-8/2012 Zur Ausgabe