Clinical significance and outcome of polymicrobial Staphylococcus aureus bacteremia

Park, Seong Yeon; Park, Ki Ho; Bang, Kyung Mi; Chong, Yong Pil; Kim, Sung-Han; Lee, Sang‐Oh; Choi, Sang‐Ho; Jeong, Jinyoung; Woo, Jun Hee; Kim, Yang Soo

doi:10.1016/j.jinf.2012.02.015

Cited by 32 publications

(33 citation statements)

References 46 publications

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“…In this study, polymicrobial blood cultures accounted for 14/106 (13%) and 3/33 (9%), respectively, of the positive blood cultures at TH and SH. Combined, polymicrobial cultures represented 17/139 (12%) of the prospective clinical blood cultures which is consistent with previous studies reporting 6 to 20% of all bloodstream infections to be polymicrobial [36–38]. BC-GP correctly identified all of the organisms in 12/17 (70%) of polymicrobial cultures.…”

Section: Discussionsupporting

confidence: 88%

Potential Impact of Rapid Blood Culture Testing for Gram-Positive Bacteremia in Japan with the Verigene Gram-Positive Blood Culture Test

Kikuchi

Mari

Iguchi

et al. 2017

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background. Early detection of Gram-positive bacteremia and timely appropriate antimicrobial therapy are required for decreasing patient mortality. The purpose of our study was to evaluate the performance of the Verigene Gram-positive blood culture assay (BC-GP) in two special healthcare settings and determine the potential impact of rapid blood culture testing for Gram-positive bacteremia within the Japanese healthcare delivery system. Furthermore, the study included simulated blood cultures, which included a library of well-characterized methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) isolates reflecting different geographical regions in Japan. Methods. A total 347 BC-GP assays were performed on clinical and simulated blood cultures. BC-GP results were compared to results obtained by reference methods for genus/species identification and detection of resistance genes using molecular and MALDI-TOF MS methodologies. Results. For identification and detection of resistance genes at two clinical sites and simulated blood cultures, overall concordance of BC-GP with reference methods was 327/347 (94%). The time for identification and antimicrobial resistance detection by BC-GP was significantly shorter compared to routine testing especially at the cardiology hospital, which does not offer clinical microbiology services on weekends and holidays. Conclusion. BC-GP generated accurate identification and detection of resistance markers compared with routine laboratory methods for Gram-positive organisms in specialized clinical settings providing more rapid results than current routine testing.

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Section: Discussionsupporting

confidence: 88%

Potential Impact of Rapid Blood Culture Testing for Gram-Positive Bacteremia in Japan with the Verigene Gram-Positive Blood Culture Test

Kikuchi

Mari

Iguchi

et al. 2017

Canadian Journal of Infectious Diseases and Medical Microbiolog

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“…The majority of these discrepancies were related to the presence of Gram-positive cocci, including S. aureus and enterococci (21). While polymicrobial blood cultures may represent contamination, the potential for significant mortality, particularly in the presence of known pathogens such as S. aureus, cannot be dismissed (24). In order for physicians to adopt and act upon results generated by these technologies, performance with regard to polymicrobial blood cultures needs to show improvement.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Microarray-Based Assay for Rapid Identification of Gram-Positive Organisms and Resistance Markers in Positive Blood Cultures

et al. 2013

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Rapid identification of pathogens directly from positive blood cultures can play a major role in reducing patient mortality rates. We evaluated the performance of the Verigene Gram-Positive Blood Culture (BC-GP) assay (Nanosphere Inc., Northbrook, IL) for detection of commonly isolated Gram-positive organisms as well as associated resistance markers from positive blood cultures. Positive blood cultures (VersaTREK; Trek Diagnostic Systems, Independence, OH) from 203 patients with Gram-positive organism infections were analyzed using the BC-GP assay within 12 h for the detection of 12 different organisms, including staphylococci, streptococci, and enterococci, as well as for the presence of 3 resistance markers (mecA, vanA, and vanB). Results were compared to those of routine laboratory methods for identification and susceptibility testing. For identification of organisms and detection of resistance markers in 178 monomicrobial positive blood cultures, the BC-GP assay showed 94% and 97% concordance, respectively, with routine methods. After 25 polymicrobial cultures were included, the results showed 92% and 96% agreement for identification and resistance markers, respectively, for a total of 203 positive cultures. In 6/25 polymicrobial cultures, at least 1 isolate was not detected. Concordance levels for detection of major pathogens such Staphylococcus aureus (n ‫؍‬ 45) and enterococci (n ‫؍‬ 19) were 98% and 95%, respectively. Agreement levels for detection of resistance markers such as mecA and vanA/B were 92% and 100%, respectively. The BC-GP assay is capable of providing rapid identification of Gram-positive cocci as well as detection of resistance markers directly from positive blood cultures at least 24 to 48 h earlier than conventional methods.

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“…58 In another study of S.aureus BSI, 2% of patients with LC were diagnosed as having staphylococcal IE. 59 Because of the majority of data regarding IE in LC come from small single-center retrospective series without any stratification regarding cirrhosis severity and evolutionary stage, the question whether a diagnosis of IE should be routinely excluded in all the cirrhotic patients with BSI, at least if a GPB is isolated, is still unresolved. In addition, it has to be considered that the referral diagnostic tool for IE diagnosis, the trans-esophageal echocardiography, could be contraindicated or dangerous in a proportion of LC patients for the risk of upper gastrointestinal bleeding.…”

Section: Clinical Findings and Complicationsmentioning

confidence: 99%

Bloodstream infections in patients with liver cirrhosis

et al. 2016

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Bloodstream infections are a serious complication in patients with liver cirrhosis. Dysregulated intestinal bacterial translocation is the predominant pathophysiological mechanism of infections in this setting. For this reason enteric Gram-negative bacteria are commonly encountered as the first etiological cause of infection. However, through the years, the improvement in the management of cirrhosis, the recourse to invasive procedures and the global spread of multidrug resistant pathogens have importantly changed the current epidemiology. Bloodstream infections in cirrhotic patients are characterized by high mortality rate and complications including metastatic infections, infective endocarditis, and endotipsitis (or transjugular intrahepatic portosystemic shunt-related infection). For this reason early identification of patients at risk for mortality and appropriated therapeutic management is mandatory. Liver cirrhosis can significantly change the pharmacokinetic behavior of antimicrobials. In fact hypoproteinaemia, ascitis and third space expansion and impairment of renal function can be translated in an unpredictable drug exposure.

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Clinical significance and outcome of polymicrobial Staphylococcus aureus bacteremia

Cited by 32 publications

References 46 publications

Potential Impact of Rapid Blood Culture Testing for Gram-Positive Bacteremia in Japan with the Verigene Gram-Positive Blood Culture Test

Potential Impact of Rapid Blood Culture Testing for Gram-Positive Bacteremia in Japan with the Verigene Gram-Positive Blood Culture Test

Evaluation of a Microarray-Based Assay for Rapid Identification of Gram-Positive Organisms and Resistance Markers in Positive Blood Cultures

Bloodstream infections in patients with liver cirrhosis

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