Clinical Significance of Molecular Diagnostic Tools for Bacterial Bloodstream Infections: A Systematic Review

Abstract

Bacterial bloodstream infection (bBSI) represents any form of invasiveness of the blood circulatory system caused by bacteria and can lead to death among critically ill patients. Thus, there is a need for rapid and accurate diagnosis and treatment of patients with septicemia. So far, different molecular diagnostic tools have been developed. The majority of these tools focus on amplification based techniques such as polymerase chain reaction (PCR) which allows the detection of nucleic acids (both DNA and small RNAs) that are specific to bacterial species and sequencing or nucleic acid hybridization that allows the detection of bacteria in order to reduce delay of appropriate antibiotic therapy. However, there is still a need to improve sensitivity of most molecular techniques to enhance their accuracy and allow exact and on time antibiotic therapy treatment. In this regard, we conducted a systematic review of the existing studies conducted in molecular diagnosis of bBSIs, with the main aim of reporting on clinical significance and benefits of molecular diagnosis to patients. We searched both Google Scholar and PubMed. In total, eighteen reviewed papers indicate that shift from conventional diagnostic methods to molecular tools is needed and would lead to accurate diagnosis and treatment of bBSI.

Prevalencia de Bartonella henselae en donantes de sangre y riesgo de transmisión sanguínea en Chile

“…La RPC representa una excelente opción para la detección de bacterias fastidiosas que infectan el torrente sanguíneo y que son difíciles de diagnosticar por los métodos tradicionales, como el hemocultivo. Los métodos moleculares reducen el tiempo de detección, aumentan la sensibilidad y especificidad y evitan resultados falsos negativos y positivos, contribuyendo a la identificación de bacterias exigentes e instauración de terapia empírica 24 . Utilizar pooles es una estrategia factible de realizar para la detección B. henselae en muestras de donantes de sangre, debido al gran número de muestras que se procesan diariamente y el tiempo de respuesta que se requiere para el diagnóstico 25 .…”

Clinical Evaluation of the iCubate iC-GPC Assay for Detection of Gram-Positive Bacteria and Resistance Markers from Positive Blood Cultures

“…Collectively, these benefits may positively impact technologist safety, workflow, costs, and throughput compared to other FDA-cleared molecular platforms and direct detection blood culture assays. Most importantly, the use of direct detection molecular blood culture assays, such as the iC-GPC Assay, will significantly reduce morbidity and mortality rates, shorten hospital stays, decrease costs, and favorably impact hospital antibiotic stewardship programs ( 25 – 29 ).…”

Targeted metagenomics using next generation sequencing in laboratory diagnosis of culture negative endophthalmitis

“…In the recent past broad range PCR assay have found use in diagnosis of infection and has been found to be more useful than uniplex or multiplex PCR assays targeted against specific pathogens. In the absence of clinical certainty, broad-range PCR assay using, primers targeting the 16S rRNA gene is particularly suitable as they are ubiquitous to all bacteria ( Rutanga and Nyirahabimana, 2016 ). However in most cases broad range PCR assay fails to identify the exact bacterial species.…”