Journal article
Multiplex PCR To Diagnose Bloodstream Infections in Patients Admitted from the Emergency Department with Sepsis
Journal of clinical microbiology, v 48(1), pp 26-33
01 Jan 2010
PMID: 19846634
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Sepsis is caused by a heterogeneous group of infectious etiologies. Early diagnosis and the provision of appropriate antimicrobial therapy correlate with positive clinical outcomes. Current microbiological techniques are limited in their diagnostic capacities and timeliness. Multiplex PCR has the potential to rapidly identify bloodstream infections and fill this diagnostic gap. We identified patients from two large academic hospital emergency departments with suspected sepsis. The results of a multiplex PCR that could detect 25 bacterial and fungal pathogens were compared to those of blood culture. The results were analyzed with respect to the likelihood of infection, sepsis severity, the site of infection, and the effect of prior antibiotic therapy. We enrolled 306 subjects with suspected sepsis. Of these, 43 were later determined not to have infectious etiologies. Of the remaining 263 subjects, 70% had sepsis, 16% had severe sepsis, and 14% had septic shock. The majority had a definite infection (41.5%) or a probable infection (30.7%). Blood culture and PCR performed similarly with samples from patients with clinically defined infections (areas under the receiver operating characteristic curves, 0.64 and 0.60, respectively). However, blood culture identified more cases of septicemia than PCR among patients with an identified infectious etiology (66 and 46, respectively;
P
= 0.0004). The two tests performed similarly when the results were stratified by sepsis severity or infection site. Blood culture tended to detect infections more frequently among patients who had previously received antibiotics (
P
= 0.06). Conversely, PCR identified an additional 24 organisms that blood culture failed to detect. Real-time multiplex PCR has the potential to serve as an adjunct to conventional blood culture, adding diagnostic yield and shortening the time to pathogen identification.
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Details
- Title
- Multiplex PCR To Diagnose Bloodstream Infections in Patients Admitted from the Emergency Department with Sepsis
- Creators
- Ephraim L. Tsalik - Duke UniversityDaphne Jones - Durham VA Medical CenterBradly Nicholson - Durham VA Medical CenterLynette Waring - Roche (United States)Oliver Liesenfeld - Roche (United States)Lawrence P. Park - Duke UniversitySeth W. Glickman - University of North Carolina at Chapel HillLauren B. Caram - Duke UniversityRaymond J. Langley - National Center for Genome ResourcesJennifer C. van Velkinburgh - National Center for Genome ResourcesCharles B. Cairns - University of North Carolina at Chapel HillEmanuel P. Rivers - Henry Ford HospitalRonny M. Otero - Henry Ford HospitalStephen F. Kingsmore - National Center for Genome ResourcesTahaniyat Lalani - Naval Medical Center PortsmouthVance G. Fowler - Duke UniversityChristopher W. Woods - Duke University
- Publication Details
- Journal of clinical microbiology, v 48(1), pp 26-33
- Publisher
- American Society for Microbiology (ASM)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000276151500002
- Scopus ID
- 2-s2.0-73949106830
- Other Identifier
- 991021448153204721
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- Collaboration types
- Industry collaboration
- Domestic collaboration
- Web of Science research areas
- Microbiology