Comparison of three different commercial PCR assays for the detection of pathogens in critically ill sepsis patients

Introduction The high mortality rate associated with sepsis necessitates a timely identification of the causative organism in order to optimize antimicrobial therapy. PCR assays are increasingly being used for this purpose. The aim of this study was to compare three commercially available PCR systems for the diagnosis of systemic infections. Patients and methods In a prospective observational study, a broad-range (SepsiTest®; Molzym, Bremen, Germany) and two multiplex PCR assays (VYOO®; SIRS-Lab, Jena, Germany and LightCycler® SeptiFast; Roche, Mannheim, Germany) were compared to blood cultures with respect to the clinical course of 50 critically ill patients with sepsis, severe sepsis or septic shock. Results Pathogens were detected by PCR in 12 % (SepsiTest®), 10 % (VYOO®) and 14 % (LightCycler® SeptiFast) of samples and in 26 % by blood culture. Negative results were obtained using all four methods in 32 samples (64 %) and 3 (6 %) samples were positive in all tests. Upon consideration of additional diagnostic findings and the clinical course, eight (16 %) of the positive blood culture results were deemed clinically relevant. All three PCR assays could also identify the causative organism (or a specific gene thereof) in three of these eight positive blood cultures, whereas for five of the eight, all three PCR assays were negative. In one patient with a negative blood culture, the SepsiTest®, VYOO® and LightCycler® SeptiFast assays were positive for Streptococcus species. The PCR assays appeared to be less susceptible than blood cultures to false-positive results arising from contamination with coagulase-negative staphylococcal organisms. Conclusion There was some variability between the three PCR assays tested and the corresponding blood cultures with regards to the type of pathogen detected. The three PCR assays appeared to be less susceptible to false-positive results than blood cultures..

Medienart:	E-Artikel

Erscheinungsjahr:	2013
Erschienen:	2013

Enthalten in:	Zur Gesamtaufnahme - volume:108
Enthalten in:	Medizinische Klinik, Intensivmedizin und Notfallmedizin - 108(2013), 4 vom: 22. März, Seite 311-318

Sprache:	Englisch

Beteiligte Personen:	Schreiber, J. [VerfasserIn] Nierhaus, A. [VerfasserIn] Braune, S.A. [VerfasserIn] de Heer, G. [VerfasserIn] Kluge, S. [VerfasserIn]

Links:	Volltext [lizenzpflichtig]

Themen:	Contamination False positive Intensive care unit (ICU) Pathogen Septic shock

Anmerkungen:	© Springer-Verlag Berlin Heidelberg 2013

doi:	10.1007/s00063-013-0227-1

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Förderinstitution / Projekttitel:

PPN (Katalog-ID):	SPR000480622