MOLECULAR IDENTIFICATION OF BLOODSTREAM PATHOGENS IN PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH SUSPECTED SEPSIS

被引:42
作者
Avolio, Manuela [1 ]
Diamante, Paola [1 ]
Zamparo, Silvio [1 ]
Modolo, Maria Luisa [1 ]
Grosso, Shamanta [1 ]
Zigante, Paola [1 ]
Tosoni, Nilla [1 ]
De Rosa, Rita [1 ]
Stano, Paola [1 ]
Camporese, Alessandro [1 ]
机构
[1] S Maria degli Angeli Reg Hosp, Microbiol & Virol Dept, Pordenone, Italy
来源
SHOCK | 2010年 / 34卷 / 01期
关键词
Molecular identification; bloodstream pathogens; emergency department; REAL-TIME PCR; BACTERIAL-MENINGITIS; DIAGNOSIS; CULTURES; INFECTIONS; CONTAMINATION; SURVEILLANCE; SAMPLES;
D O I
10.1097/SHK.0b013e3181d49299
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
The rapid detection of pathogens in blood is critical for a favorable outcome of patients with suspected sepsis. Although blood culture (BC) is considered the criterion standard for diagnosis of bloodstream infection, it often takes several days to detect the causative organism. In this study, we compared BC with a commercially available multiplex real-time polymerase chain reaction (PCR) assay to detect bacteria and fungi in blood samples from 144 patients admitted to the emergency department with suspected sepsis. Of 144 blood samples examined, 91 (63%) were negative by both methods and 53 (37%) were positive by at least one of the two methods. In 30 among all positive cases (56.6%), both methods identified the same organisms, in 13 cases (24.5%), BC identified organisms not detected by real-time PCR, and in 10 cases (18.9%), SeptiFast PCR assay gave positive results, whereas the BC was negative. In this study, we wished to compare SeptiFast results obtained by standard procedures, but future clinical studies are necessary to define SeptiFast PCR as support for BC in the early diagnosis of severe bloodstream infections.
引用
收藏
页码:27 / 30
页数:4
相关论文
共 22 条
[1]   Advances in the microbiological diagnosis of sepsis [J].
Andrade, Soraya S. ;
Bispo, Paulo J. M. ;
Gales, Ana C. .
SHOCK, 2008, 30 :41-46
[2]  
Avolio Manuela, 2009, Infez Med, V17, P184
[3]  
Avolio M, 2009, NEW MICROBIOL, V32, P179
[4]   Prolonged incubation and extensive subculturing do not increase recovery of clinically significant microorganisms from standard automated blood cultures [J].
Baron, EJ ;
Scott, JD ;
Tompkins, LS .
CLINICAL INFECTIOUS DISEASES, 2005, 41 (11) :1677-1680
[5]   TOWARD AN EPIDEMIOLOGY AND NATURAL-HISTORY OF SIRS (SYSTEMIC INFLAMMATORY RESPONSE SYNDROME) [J].
BONE, RC .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1992, 268 (24) :3452-3455
[6]   Bloodstream infections:: A trial of the impact of different methods of reporting positive blood culture results [J].
Bouza, E ;
Sousa, D ;
Muñoz, P ;
Rodríguez-Créixems, M ;
Fron, C ;
Lechuz, JG .
CLINICAL INFECTIOUS DISEASES, 2004, 39 (08) :1161-1169
[7]   Chlorhexidine compared with povidone-iodine solution for vascular catheter-site care: A meta-analysis [J].
Chaiyakunapruk, N ;
Veenstra, DL ;
Lipsky, BA ;
Saint, S .
ANNALS OF INTERNAL MEDICINE, 2002, 136 (11) :792-801
[8]   Diagnosis and treatment of prosthetic aortic graft infections: confusion and inconsistency in the absence of evidence or consensus [J].
FitzGerald, SF ;
Kelly, C ;
Humphreys, H .
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2005, 56 (06) :996-999
[9]  
Grosso S, 2008, NEW MICROBIOL, V31, P501
[10]   Detection of bloodstream infections in adults: How many blood cultures are needed? [J].
Lee, Andrew ;
Mirrett, Stanley ;
Reller, L. Barth ;
Weinstein, Melvin P. .
JOURNAL OF CLINICAL MICROBIOLOGY, 2007, 45 (11) :3546-3548