Cargando…
Substantial diagnostic impact of blood culture independent molecular methods in bloodstream infections: Superior performance of PCR/ESI-MS
This study analyzed the performance of different molecular technologies along with blood culture (BC) in the diagnosis of bloodstream infections (BSI) in patients from internal medicine wards - including intensive care units (ICUs) - and the emergency room. Patients with systemic inflammatory respon...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207717/ https://www.ncbi.nlm.nih.gov/pubmed/30375435 http://dx.doi.org/10.1038/s41598-018-34298-7 |
_version_ | 1783366568836595712 |
---|---|
author | Makristathis, Athanasios Harrison, Nicole Ratzinger, Franz Kussmann, Manuel Selitsch, Brigitte Forstner, Christina Hirschl, Alexander M. Burgmann, Heinz |
author_facet | Makristathis, Athanasios Harrison, Nicole Ratzinger, Franz Kussmann, Manuel Selitsch, Brigitte Forstner, Christina Hirschl, Alexander M. Burgmann, Heinz |
author_sort | Makristathis, Athanasios |
collection | PubMed |
description | This study analyzed the performance of different molecular technologies along with blood culture (BC) in the diagnosis of bloodstream infections (BSI) in patients from internal medicine wards - including intensive care units (ICUs) - and the emergency room. Patients with systemic inflammatory response syndrome were prospectively included. BCs and EDTA whole blood were obtained simultaneously. The latter was analyzed by PCR combined with electrospray ionization mass spectrometry (PCR/ESI-MS; IRIDICA BAC BSI assay, Abbott) and by SeptiFast (Roche). Cases were classified as BSI according to adapted European Centre for Disease Prevention and Control criteria. Out of 462 analyzed episodes, 193 with valid test results fulfilled the inclusion criteria and were further evaluated. Sixty-nine (35.8%) were classified as BSI. PCR/ESI-MS showed a significantly better overall performance than BC (p = 0.004) or SeptiFast (p = 0.034). Only in patients from the ICU the performance of SeptiFast was comparable to that of PCR/ESI-MS. Mainly due to the negative effect of antimicrobial pre-treatment on BC results, the cumulative performance of each of the molecular tests with BC was significantly higher than that of BC alone (p < 0.001). SeptiFast and in particular the broad-range pathogen detection system PCR/ESI-MS proved to be an essential addition to BC-based diagnostics in BSI. |
format | Online Article Text |
id | pubmed-6207717 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-62077172018-11-01 Substantial diagnostic impact of blood culture independent molecular methods in bloodstream infections: Superior performance of PCR/ESI-MS Makristathis, Athanasios Harrison, Nicole Ratzinger, Franz Kussmann, Manuel Selitsch, Brigitte Forstner, Christina Hirschl, Alexander M. Burgmann, Heinz Sci Rep Article This study analyzed the performance of different molecular technologies along with blood culture (BC) in the diagnosis of bloodstream infections (BSI) in patients from internal medicine wards - including intensive care units (ICUs) - and the emergency room. Patients with systemic inflammatory response syndrome were prospectively included. BCs and EDTA whole blood were obtained simultaneously. The latter was analyzed by PCR combined with electrospray ionization mass spectrometry (PCR/ESI-MS; IRIDICA BAC BSI assay, Abbott) and by SeptiFast (Roche). Cases were classified as BSI according to adapted European Centre for Disease Prevention and Control criteria. Out of 462 analyzed episodes, 193 with valid test results fulfilled the inclusion criteria and were further evaluated. Sixty-nine (35.8%) were classified as BSI. PCR/ESI-MS showed a significantly better overall performance than BC (p = 0.004) or SeptiFast (p = 0.034). Only in patients from the ICU the performance of SeptiFast was comparable to that of PCR/ESI-MS. Mainly due to the negative effect of antimicrobial pre-treatment on BC results, the cumulative performance of each of the molecular tests with BC was significantly higher than that of BC alone (p < 0.001). SeptiFast and in particular the broad-range pathogen detection system PCR/ESI-MS proved to be an essential addition to BC-based diagnostics in BSI. Nature Publishing Group UK 2018-10-30 /pmc/articles/PMC6207717/ /pubmed/30375435 http://dx.doi.org/10.1038/s41598-018-34298-7 Text en © The Author(s) 2018 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Makristathis, Athanasios Harrison, Nicole Ratzinger, Franz Kussmann, Manuel Selitsch, Brigitte Forstner, Christina Hirschl, Alexander M. Burgmann, Heinz Substantial diagnostic impact of blood culture independent molecular methods in bloodstream infections: Superior performance of PCR/ESI-MS |
title | Substantial diagnostic impact of blood culture independent molecular methods in bloodstream infections: Superior performance of PCR/ESI-MS |
title_full | Substantial diagnostic impact of blood culture independent molecular methods in bloodstream infections: Superior performance of PCR/ESI-MS |
title_fullStr | Substantial diagnostic impact of blood culture independent molecular methods in bloodstream infections: Superior performance of PCR/ESI-MS |
title_full_unstemmed | Substantial diagnostic impact of blood culture independent molecular methods in bloodstream infections: Superior performance of PCR/ESI-MS |
title_short | Substantial diagnostic impact of blood culture independent molecular methods in bloodstream infections: Superior performance of PCR/ESI-MS |
title_sort | substantial diagnostic impact of blood culture independent molecular methods in bloodstream infections: superior performance of pcr/esi-ms |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207717/ https://www.ncbi.nlm.nih.gov/pubmed/30375435 http://dx.doi.org/10.1038/s41598-018-34298-7 |
work_keys_str_mv | AT makristathisathanasios substantialdiagnosticimpactofbloodcultureindependentmolecularmethodsinbloodstreaminfectionssuperiorperformanceofpcresims AT harrisonnicole substantialdiagnosticimpactofbloodcultureindependentmolecularmethodsinbloodstreaminfectionssuperiorperformanceofpcresims AT ratzingerfranz substantialdiagnosticimpactofbloodcultureindependentmolecularmethodsinbloodstreaminfectionssuperiorperformanceofpcresims AT kussmannmanuel substantialdiagnosticimpactofbloodcultureindependentmolecularmethodsinbloodstreaminfectionssuperiorperformanceofpcresims AT selitschbrigitte substantialdiagnosticimpactofbloodcultureindependentmolecularmethodsinbloodstreaminfectionssuperiorperformanceofpcresims AT forstnerchristina substantialdiagnosticimpactofbloodcultureindependentmolecularmethodsinbloodstreaminfectionssuperiorperformanceofpcresims AT hirschlalexanderm substantialdiagnosticimpactofbloodcultureindependentmolecularmethodsinbloodstreaminfectionssuperiorperformanceofpcresims AT burgmannheinz substantialdiagnosticimpactofbloodcultureindependentmolecularmethodsinbloodstreaminfectionssuperiorperformanceofpcresims |