Rapid identification of bacteria and <it>candida</it> using pna-fish from blood and peritoneal fluid cultures: a retrospective clinical study
<p>Abstract</p> <p>Background</p> <p>Peptide nucleic acid fluorescent <it>in situ</it> hybridization (PNA-FISH) is a rapid and established method for identification of <it>Candida</it> sp., Gram positive, and Gram negative bacteria from positive...
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| Format: | Article |
| Language: | English |
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BMC
2013-01-01
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| Series: | Annals of Clinical Microbiology and Antimicrobials |
| Subjects: | |
| Online Access: | http://www.ann-clinmicrob.com/content/12/1/2 |
| _version_ | 1818068062524407808 |
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| author | Harris Dana M Hata D Jane |
| author_facet | Harris Dana M Hata D Jane |
| author_sort | Harris Dana M |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Peptide nucleic acid fluorescent <it>in situ</it> hybridization (PNA-FISH) is a rapid and established method for identification of <it>Candida</it> sp., Gram positive, and Gram negative bacteria from positive blood cultures. This study reports clinical experience in the evaluation of 103 positive blood cultures and 17 positive peritoneal fluid cultures from 120 patients using PNA-FISH. Our study provides evidence as to potential pharmaceutical cost savings based on rapid pathogen identification, in addition to the novel application of PNA-FISH to peritoneal fluid specimens.</p> <p>Methods</p> <p>Identification accuracy and elapsed time to identification of Gram positives, Gram negatives, and <it>Candida</it> sp., isolated from blood and peritoneal fluid cultures were assessed using PNA-FISH (AdvanDx), as compared to standard culture methods. Patient charts were reviewed to extrapolate potential pharmaceutical cost savings due to adjustment of antimicrobial or antifungal therapy, based on identification by PNA-FISH.</p> <p>Results</p> <p>In blood cultures, time to identification by standard culture methods for bacteria and <it>Candida</it> sp., averaged 83.6 hours (95% CI 56.7 to 110.5). Identification by PNA-FISH averaged 11.2 hours (95% CI 4.8 to 17.6). Overall PNA-FISH identification accuracy was 98.8% (83/84, 95% CI 93.5% to 99.9%) as compared to culture. In peritoneal fluid, identification of bacteria by culture averaged 87.4 hours (95% CI −92.4 to 267.1). Identification by PNA-FISH averaged 16.4 hours (95% CI −57.3 to 90.0). Overall PNA-FISH identification accuracy was 100% (13/13, 95% CI 75.3% to 100%). For <it>Candida</it> sp., pharmaceutical cost savings based on PNA-FISH identification could be $377.74/day. For coagulase-negative staphylococcus (CoNS), discontinuation of vancomycin could result in savings of $20.00/day.</p> <p>Conclusions</p> <p>In this retrospective study, excellent accuracy of PNA-FISH in blood and peritoneal fluids with reduced time to identification was observed, as compared to conventional culture-based techniques. Species-level identification based on PNA-FISH could contribute to notable cost savings due to adjustments in empiric antimicrobial or antifungal therapy as appropriate to the pathogen identified.</p> |
| first_indexed | 2024-12-10T15:33:36Z |
| format | Article |
| id | doaj.art-43833249115d4fdca73e892f1f67f5e9 |
| institution | Directory Open Access Journal |
| issn | 1476-0711 |
| language | English |
| last_indexed | 2024-12-10T15:33:36Z |
| publishDate | 2013-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Annals of Clinical Microbiology and Antimicrobials |
| spelling | doaj.art-43833249115d4fdca73e892f1f67f5e92022-12-22T01:43:19ZengBMCAnnals of Clinical Microbiology and Antimicrobials1476-07112013-01-01121210.1186/1476-0711-12-2Rapid identification of bacteria and <it>candida</it> using pna-fish from blood and peritoneal fluid cultures: a retrospective clinical studyHarris Dana MHata D Jane<p>Abstract</p> <p>Background</p> <p>Peptide nucleic acid fluorescent <it>in situ</it> hybridization (PNA-FISH) is a rapid and established method for identification of <it>Candida</it> sp., Gram positive, and Gram negative bacteria from positive blood cultures. This study reports clinical experience in the evaluation of 103 positive blood cultures and 17 positive peritoneal fluid cultures from 120 patients using PNA-FISH. Our study provides evidence as to potential pharmaceutical cost savings based on rapid pathogen identification, in addition to the novel application of PNA-FISH to peritoneal fluid specimens.</p> <p>Methods</p> <p>Identification accuracy and elapsed time to identification of Gram positives, Gram negatives, and <it>Candida</it> sp., isolated from blood and peritoneal fluid cultures were assessed using PNA-FISH (AdvanDx), as compared to standard culture methods. Patient charts were reviewed to extrapolate potential pharmaceutical cost savings due to adjustment of antimicrobial or antifungal therapy, based on identification by PNA-FISH.</p> <p>Results</p> <p>In blood cultures, time to identification by standard culture methods for bacteria and <it>Candida</it> sp., averaged 83.6 hours (95% CI 56.7 to 110.5). Identification by PNA-FISH averaged 11.2 hours (95% CI 4.8 to 17.6). Overall PNA-FISH identification accuracy was 98.8% (83/84, 95% CI 93.5% to 99.9%) as compared to culture. In peritoneal fluid, identification of bacteria by culture averaged 87.4 hours (95% CI −92.4 to 267.1). Identification by PNA-FISH averaged 16.4 hours (95% CI −57.3 to 90.0). Overall PNA-FISH identification accuracy was 100% (13/13, 95% CI 75.3% to 100%). For <it>Candida</it> sp., pharmaceutical cost savings based on PNA-FISH identification could be $377.74/day. For coagulase-negative staphylococcus (CoNS), discontinuation of vancomycin could result in savings of $20.00/day.</p> <p>Conclusions</p> <p>In this retrospective study, excellent accuracy of PNA-FISH in blood and peritoneal fluids with reduced time to identification was observed, as compared to conventional culture-based techniques. Species-level identification based on PNA-FISH could contribute to notable cost savings due to adjustments in empiric antimicrobial or antifungal therapy as appropriate to the pathogen identified.</p>http://www.ann-clinmicrob.com/content/12/1/2PNA-FISHBlood cultureBacteremiaFungemiaPeritoneal fluid |
| spellingShingle | Harris Dana M Hata D Jane Rapid identification of bacteria and <it>candida</it> using pna-fish from blood and peritoneal fluid cultures: a retrospective clinical study Annals of Clinical Microbiology and Antimicrobials PNA-FISH Blood culture Bacteremia Fungemia Peritoneal fluid |
| title | Rapid identification of bacteria and <it>candida</it> using pna-fish from blood and peritoneal fluid cultures: a retrospective clinical study |
| title_full | Rapid identification of bacteria and <it>candida</it> using pna-fish from blood and peritoneal fluid cultures: a retrospective clinical study |
| title_fullStr | Rapid identification of bacteria and <it>candida</it> using pna-fish from blood and peritoneal fluid cultures: a retrospective clinical study |
| title_full_unstemmed | Rapid identification of bacteria and <it>candida</it> using pna-fish from blood and peritoneal fluid cultures: a retrospective clinical study |
| title_short | Rapid identification of bacteria and <it>candida</it> using pna-fish from blood and peritoneal fluid cultures: a retrospective clinical study |
| title_sort | rapid identification of bacteria and it candida it using pna fish from blood and peritoneal fluid cultures a retrospective clinical study |
| topic | PNA-FISH Blood culture Bacteremia Fungemia Peritoneal fluid |
| url | http://www.ann-clinmicrob.com/content/12/1/2 |
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