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

<p>Abstract</p> <p>Background</p> <p>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 cu...

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Main Authors: Linde Hans-Jörg, Siebig Sylvia, Ehrenstein Boris, Dierkes Christine, Reischl Udo, Salzberger Bernd
Format: Article
Language:English
Published: BMC 2009-08-01
Series:BMC Infectious Diseases
Online Access:http://www.biomedcentral.com/1471-2334/9/126
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author Linde Hans-Jörg
Siebig Sylvia
Ehrenstein Boris
Dierkes Christine
Reischl Udo
Salzberger Bernd
author_facet Linde Hans-Jörg
Siebig Sylvia
Ehrenstein Boris
Dierkes Christine
Reischl Udo
Salzberger Bernd
author_sort Linde Hans-Jörg
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>Blood samples from patients with presumed sepsis were cultured with the Bactec 9240™ system (Becton Dickinson, Heidelberg, Germany) and aliquots subjected to analysis with the LightCycler<sup>® </sup>SeptiFast<sup>® </sup>(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.</p> <p>Results</p> <p>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%).</p> <p>Conclusion</p> <p>The addition of multiplex PCR to conventional blood cultures had a relevant impact on clinical management for a subset of patients with presumed sepsis.</p>
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spelling doaj.art-30774cfb0a094ea3ae1042fb8e25e2982022-12-22T03:14:28ZengBMCBMC Infectious Diseases1471-23342009-08-019112610.1186/1471-2334-9-126Clinical impact of a commercially available multiplex PCR system for rapid detection of pathogens in patients with presumed sepsisLinde Hans-JörgSiebig SylviaEhrenstein BorisDierkes ChristineReischl UdoSalzberger Bernd<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>Blood samples from patients with presumed sepsis were cultured with the Bactec 9240™ system (Becton Dickinson, Heidelberg, Germany) and aliquots subjected to analysis with the LightCycler<sup>® </sup>SeptiFast<sup>® </sup>(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.</p> <p>Results</p> <p>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%).</p> <p>Conclusion</p> <p>The addition of multiplex PCR to conventional blood cultures had a relevant impact on clinical management for a subset of patients with presumed sepsis.</p>http://www.biomedcentral.com/1471-2334/9/126
spellingShingle Linde Hans-Jörg
Siebig Sylvia
Ehrenstein Boris
Dierkes Christine
Reischl Udo
Salzberger Bernd
Clinical impact of a commercially available multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis
BMC Infectious Diseases
title Clinical impact of a commercially available multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis
title_full Clinical impact of a commercially available multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis
title_fullStr Clinical impact of a commercially available multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis
title_full_unstemmed Clinical impact of a commercially available multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis
title_short Clinical impact of a commercially available multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis
title_sort clinical impact of a commercially available multiplex pcr system for rapid detection of pathogens in patients with presumed sepsis
url http://www.biomedcentral.com/1471-2334/9/126
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