A retrospective evaluation of a multiplex polymerase chain reaction test directly applied to blood for the management of sepsis in the critically ill.
ICU
PCR
blood culture
bloodstream infections
critically illness
polymerase chain reaction
sepsis
Journal
The Southern African journal of critical care : the official journal of the Critical Care Society
ISSN: 2078-676X
Titre abrégé: South Afr J Crit Care
Pays: South Africa
ID NLM: 8801525
Informations de publication
Date de publication:
2021
2021
Historique:
accepted:
04
08
2021
entrez:
6
5
2022
pubmed:
7
5
2022
medline:
7
5
2022
Statut:
epublish
Résumé
Blood culture (BC) is the established gold standard for microbiological diagnosis of bloodstream infection (BSI); however, its sensitivity is poor. The primary objective was to determine the sensitivity and specificity of the Magicplex Sepsis Real-time Test, a multiplex polymerase chain reaction test (mPCR), and BC to detect BSIs. Secondary outcomes included determining the prevalence of BSIs. A retrospective review of a technical evaluation of the mPCR. Patients requiring BC had a blood sample collected for mPCR. The respective sensitivity and specificity of mPCR for the detection of BSI were 50% (n=7/14) and 58% (n=18/31), while the sensitivity and specificity using BC were 36% (n=5/14) and 68% (n=21/31), respectively. The addition of mPCR to BC increased BSI detection during sepsis from 36% to 64%. The use of mPCR directly applied to blood may increase the detection of micro-organisms associated with BSIs in critically ill patients requiring BC investigation. Our data add to a growing body of evidence indicating that mPCR applied directly to blood prior to incubation increases the detection of pathogenic bacteria among hospitalised patients for whom blood cultures are performed for suspected infection. Our study was performed in a low-to-middle income country with a higher sepsis prevalence, a greater burden of multidrug-resistant organisms and clinically defined sepsis. This strengthens the robustness and generalisability of this body of evidence.
Sections du résumé
Background
UNASSIGNED
Blood culture (BC) is the established gold standard for microbiological diagnosis of bloodstream infection (BSI); however, its sensitivity is poor.
Objectives
UNASSIGNED
The primary objective was to determine the sensitivity and specificity of the Magicplex Sepsis Real-time Test, a multiplex polymerase chain reaction test (mPCR), and BC to detect BSIs. Secondary outcomes included determining the prevalence of BSIs.
Methods
UNASSIGNED
A retrospective review of a technical evaluation of the mPCR. Patients requiring BC had a blood sample collected for mPCR.
Results
UNASSIGNED
The respective sensitivity and specificity of mPCR for the detection of BSI were 50% (n=7/14) and 58% (n=18/31), while the sensitivity and specificity using BC were 36% (n=5/14) and 68% (n=21/31), respectively. The addition of mPCR to BC increased BSI detection during sepsis from 36% to 64%.
Conclusion
UNASSIGNED
The use of mPCR directly applied to blood may increase the detection of micro-organisms associated with BSIs in critically ill patients requiring BC investigation.
Contributions of the study
UNASSIGNED
Our data add to a growing body of evidence indicating that mPCR applied directly to blood prior to incubation increases the detection of pathogenic bacteria among hospitalised patients for whom blood cultures are performed for suspected infection. Our study was performed in a low-to-middle income country with a higher sepsis prevalence, a greater burden of multidrug-resistant organisms and clinically defined sepsis. This strengthens the robustness and generalisability of this body of evidence.
Identifiants
pubmed: 35517850
doi: 10.7196/SAJCC.2021.v37i3.495
pmc: PMC9053419
doi:
Types de publication
Journal Article
Langues
eng
Déclaration de conflit d'intérêts
Conflicts of interest: None.
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