Comparison of DNA probe technology and automated continuous-monitoring blood culture systems in the detection of neonatal bacteremia

被引：5

作者：

Hertz D. ^{[1
,6
]}

Fuller D. ^{[2
]}

Davis T. ^{[2
]}

Papile L. ^{[3
]}

Stevenson D. ^{[4
,5
]}

Lemons J. ^{[1
]}

机构：

[1] Department of Pediatrics, Indiana University, Indianapolis, IN

[2] Department of Microbiology, Indiana University, Indianapolis, IN

[3] Department of Pediatrics, University of New Mexico, Albuquerque, NM

[4] Department of Pediatrics, Stanford University, Palo Alto, CA

[5] Natl. Inst. Child Hlth. Hum. D., Bethesda, MD

[6] Riley Hospital for Children, Indianapolis, IN 46202, 702 Barnbill Drive

来源：

Journal of Perinatology | 1999年 / 19卷 / 4期

关键词：

D O I：

10.1038/sj.jp.7200156

中图分类号：

学科分类号：

摘要：

OBJECTIVE: The present study assessed the ability of a rapid chemiluminescent DNA probe assay to detect bacterial growth in blood culture specimens before their detection by continuous-monitoring blood culture (CMBC) systems. STUDY DESIGN: Three newborn intensive care units, which are members of the National Institute of Child Health and Human Development Neonatal Research Network, participated in this study. Each center employs an automated CMBC system against which the DNA probe was compared. A total of 1700 blood cultures were analyzed. A 3-ml aliquot of culture medium was removed from each culture during early incubation, processed, and analyzed by the DNA probe. RESULTS: Of 1700 blood cultures, 130 (7.6%) were detected positive by a CMBC system. Coagulase-negative staphylococci (CNS) were present in 90 (69%) of the positive cultures, and 26 (29%) were detected by the DNA probe. Other organisms accounted for the remaining 40 positive cultures, and 31 (78%) of these were detected by the probe assay. Seventy-six percent of all positive cultures were detected by a CMBC system within 24 hours. Ninety-eight percent of all positive cultures were detected by a CMBC system within 48 hours. Of the two organisms that grew in a CMBC system beyond 48 hours, both were CNS and one of these was considered a contaminant. Therefore, 99% of clinically significant organisms were detected by a CMBC system within 48 hours. CONCLUSION: This DNA probe is not sufficiently sensitive to be clinically useful; however, automated CMBC systems are sufficiently sensitive to aid in clinical decision-making regarding the continuance or discontinuance of antibiotic therapy following 48 hours of culture incubation.

引用

页码：290 / 293

页数：3

共 20 条

[1] Brown A.S., Hoelzer D.J., Piercy S.A., Skin necrosis form extravasation of intravenous fluids in children, Plast Reconstr Surg, 64, pp. 145-150, (1979)
[2] Phelps S.J., Helms R.A., Risk factors affecting infiltration of peripheral venous lines in infants, J Pediatr, 111, pp. 384-389, (1987)
[3] Vincer M.J., Murray J.M., Yuill A., Et al., Drug errors and incidents in a neonatal intensive care unit, AJDC, 143, pp. 737-740, (1989)
[4] Wilson M.L., Weinstein M.P., Rellar L.B., Automated blood culture systems, Clin Lab Med, 14, pp. 149-168, (1994)
[5] Kohne D.E., The use of DNA probes to detect and identify microorganisms, Adv Exp Med Biol, 263, pp. 11-35, (1990)
[6] Davis T.E., Fuller D.D., Direct identification of bacterial isolates in blood cultures by using a DNA probe, J Clin Microbiol, 29, pp. 2193-2196, (1991)
[7] Lemons J.A., Hertz D.E., Fuller D.D., Davis T.E., Early detection of bacteremia by DNA probe technology, Neonatal Monitor, 10, pp. 6-8, (1994)
[8] Escobar G.J., Zukin T., Usatin M.S., Et al., Early discontinuation of antibiotic treatment in newborns admitted to rule out sepsis: A decision rule, Pediatr Infect Dis J, 13, pp. 860-866, (1994)
[9] Siegel J.D., Neonatal sepsis, Semin Perinatol, 9, pp. 20-28, (1985)
[10] Stoll B.J., Gordon T.G., Korones S.B., Et al., Late-onset sepsis in very low birth wight neonates: A report from the National Institute of Child Health and Human Development Neonatal Research Network, J Pediatr, 129, pp. 63-71, (1996)

← 1 2 →