Real-Time Polymerase Chain Reaction for Detecting Bacterial DNA Directly from Blood of Neonates Being Evaluated for Sepsis

Jordan, Jeanne A.; Durso, Mary Beth

doi:10.1016/s1525-1578(10)60590-9

Cited by 146 publications

(120 citation statements)

References 21 publications

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“…21,[37][38][39] Inhibition of PCR has been observed when leukocytosis is greater than 30 000/µL, probably because of competition between the relatively low level of bacterial DNA and the high level of human genomic DNA. 10,40 In our case, the absence of leukocytosis in the aforementioned range suggests that the low false-negative rate is due to low-level bacteremia. Furthermore, DNA was not amplified in 15% of episodes, which is consistent with findings from other studies.…”

Section: Discussionmentioning

confidence: 54%

Microbiological Diagnosis of Sepsis: Polymerase Chain Reaction System Versus Blood Cultures

Suberviola

Márquez-López

Castellanos-Ortega

et al. 2015

American Journal of Critical Care

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Objective To compare the utility of a multiplex polymerase chain reaction system (SeptiFast) and blood cultures for detecting bacteria and fungi in blood samples from patients with severe sepsis or septic shock. Methods In a prospective observational study, whole blood samples for SeptiFast testing and for culture were collected on admission from all patients with severe sepsis or septic shock admitted to the intensive care unit between July 2011 and September 2012. SeptiFast results were compared with blood and other culture results. Results The probability of at least 1 microorganism being isolated at 6 hours was 13-fold higher with the SeptiFast test than with blood cultures (relative risk, 13.5; 95% CI, 5.05-36.06). Unlike culture results, SeptiFast test results were not associated with previous antibiotic consumption. The median time to the first positive blood culture result was 17 hours; SeptiFast results were available in 6 hours. SeptiFast detected genetic material from potentially multiresistant microorganisms in patients whose blood cultures showed no growth at all. Conclusions The SeptiFast test provided quicker microbiological diagnosis and identified significantly more microorganisms than blood cultures did, particularly when samples were collected after antibiotic therapy had started or infections were due to resistant bacteria and yeast.

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Section: Discussionmentioning

confidence: 54%

Microbiological Diagnosis of Sepsis: Polymerase Chain Reaction System Versus Blood Cultures

Suberviola

Márquez-López

Castellanos-Ortega

et al. 2015

American Journal of Critical Care

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“…The positive predictive value of their broadrange PCR was only 59 %, but the specificity was 90 % and several clinical cases of neonatal sepsis could be confirmed by the molecular technique with negative cultures. Jordan et al developed a real-time PCR targeting the 16S rRNA with a turnaround time of less than 5 h, which showed a good analytical sensitivity for the detection of pathogens in the blood of infants evaluated for EOS [60].…”

Section: Pcr On Whole Blood and Other Sterile Fluids Of Septic Neonatesmentioning

confidence: 99%

Molecular-based Screening for Perinatal Group B Streptococcal Infection: Implications for Prevention and Therapy

2013

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Group B streptococci (GBS) are a leading cause of infectious neonatal morbidity and mortality. Timely and accurate identification of colonized pregnant women is imperative to implement intrapartum antibioprophylaxis (IAP) to reduce the risk of early neonatal sepsis. Current guidelines recommend screening for GBS carriage with vaginal-rectal cultures. However, cultures require 24-72 h, thus precluding their use for intrapartum screening and these are only performed at 35-37 weeks gestation. New rapid molecular-based tests can detect GBS within hours. They have the potential to be used intrapartum and to allow for selective IAP in women carrying GBS. An advantage is that they can sometimes be performed by non-laboratory staff in the labor suite, thus avoiding delays in sample transfers to the microbiology laboratory. Another possible use of molecular-based assays is for the diagnosis of neonatal sepsis, where tests with a short turnaround time and high sensitivity and specificity are crucial. In this situation, the detection of microorganisms once antibiotic therapy has already been started is important, as treatment is started immediately once sepsis is suspected without waiting for microbiological confirmation. In this article, we discuss the state-of-the-art molecular-based tests available for GBS screening during pregnancy, as well as their implications for IAP for the diagnosis and prevention of neonatal sepsis.

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“…Different nucleic acid detection tests have been developed for detection of bacteremia and fungemia and have shown promising results in improving the diagnosis of bloodstream infections [5][6][7][8][9][10][11]. A multiplex real-time polymerase chain reaction (PCR) assay -SeptiFast (Roche Diagnostics) -is commercially available for the detection of bacteria and fungi directly from blood [12].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic performance and therapeutic impact of LightCycler SeptiFast assay in patients with suspected sepsis

Herne¹,

Nelovkov²,

Kutt³

et al. 2013

European Journal of Microbiology and Immunology

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Rapid and reliable identification of pathogens is very important in the management of septic patients. We retrospectively evaluated the diagnostic accuracy and clinical utility of a multiplex real-time polymerase chain reaction (PCR) assay (SeptiFast (SF)) in patients with suspected sepsis in a tertiary care hospital in Tallinn, Estonia. A total of 160 blood samples from 144 patients were included in the study. SF results were compared with corresponding blood culture (BC) results. The concordance between SF and BC was 78.8%. The rate of positive results was significantly higher in SF than in BC (33.7% vs. 21.2%, respectively; p < 0.001). A total of 27 samples were found positive by both SF and BC, 27 by SF only, and seven by BC only. Of a total of 83 microorganisms detected SF identified 71, and BC 42 (p < 0.001). SF detected markedly more patients with candidemia: 11 patients were detected by SF compared to four patients by BC. Antimicrobial treatment was changed in 21 (38.9%) of 54 SF positive cases. In conclusion, our results demonstrated the high diagnostic accuracy of SF in detection of sepsis pathogens. In conjunction with its impact on therapeutic decisions, SF proved to be a useful adjunct to conventional blood culture in the diagnosis of sepsis etiology.

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Real-Time Polymerase Chain Reaction for Detecting Bacterial DNA Directly from Blood of Neonates Being Evaluated for Sepsis

Cited by 146 publications

References 21 publications

Microbiological Diagnosis of Sepsis: Polymerase Chain Reaction System Versus Blood Cultures

Microbiological Diagnosis of Sepsis: Polymerase Chain Reaction System Versus Blood Cultures

Molecular-based Screening for Perinatal Group B Streptococcal Infection: Implications for Prevention and Therapy

Diagnostic performance and therapeutic impact of LightCycler SeptiFast assay in patients with suspected sepsis

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