Izvorni znanstveni članak
SeptiFast Real-Time PCR for Detection of Bloodborne Pathogens in Patients with Severe Sepsis or Septic Shock
Andrej Markota
; University Medical Centre Maribor, Medical Intensive Care Unit, Maribor, Slovenia
Katja Seme
; University of Ljubljana, Faculty of Medicine, Institute of Microbiology and Immunology, Ljubljana, Slovenia
Andrej Golle
; Institute of Public Health Maribor, Centre for Microbiology, Maribor, Slovenia
Mario Poljak
; University of Ljubljana, Faculty of Medicine, Institute of Microbiology and Immunology, Ljubljana, Slovenia
Andreja Sinkovič
; University Medical Centre Maribor, Medical Intensive Care Unit, Maribor, Slovenia
Sažetak
Several studies have been performed investigating the role of a real-time multiplex polymerase chain reaction assay LightCycler® SeptiFast® with inconsistent results. In prospective evaluation of adult patients with severe sepsis or septic shock SeptiFast assay and blood culture results were compared regarding concordance, the impact of SeptiFast assay on antimicrobial therapy adjustment, time to results and the role of SeptiFast assay as a marker of disease severity. 63 blood sample sets were collected from 57 patients. 51 (80.9%) results were concordant negative and 7 (11.1%) concordant positive. In one (1.6%) sample set blood culture was positive and SeptiFast assay negative, in three (4.8%) sample sets with negative blood cultures pathogens were detected by SeptiFast assay and in one (1.6%) patient an additional pathogen was detected by SeptiFast assay. If blood culture is considered as „gold standard“, 1 (1.6%) SeptiFast false negative and 4 (6.3%) false positive results were identified (sensitivity 87.5%, specificity 92.6%, negative predictive value 97.8%). Antibiotic treatment was adjusted according to SeptiFast assay in 4 (6.3%) cases. Time to final results was significantly shorter with SeptiFast assay (32 ± 23 h vs. 97 ± 28 h, p<0.0001). Positive SeptiFast assay was not associated with higher mortality, C-reactive protein or procalcitonin (p=0.74, p=0.44 and p=0.12, respectively). According to our results SeptiFast assay can be used as a valuable add-on to blood culture in diagnostic workup of patients with severe sepsis and septic shock but it cannot replace the blood culture.
Ključne riječi
sepsis; polymerase chain reaction; blood cultures; antimicrobial agents; pathogen identification
Hrčak ID:
128177
URI
Datum izdavanja:
30.9.2014.
Posjeta: 930 *