Email updates

Keep up to date with the latest news and content from BMC Infectious Diseases and BioMed Central.

Open Access Highly Accessed Research article

Clinical impact of a commercially available multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis

Christine Dierkes1*, Boris Ehrenstein1, Sylvia Siebig1, Hans-Jörg Linde2, Udo Reischl2 and Bernd Salzberger1

Author Affiliations

1 Department of Internal Medicine I, University Hospital Regensburg, 93042 Regensburg, Germany

2 Institute of Medical Microbiology and Hygiene, University of Regensburg, 93042 Regensburg, Germany

For all author emails, please log on.

BMC Infectious Diseases 2009, 9:126  doi:10.1186/1471-2334-9-126

Published: 11 August 2009

Abstract

Background

Timely identification of pathogens is crucial to minimize mortality in patients with severe infections. Detection of bacterial and fungal pathogens in blood by nucleic acid amplification promises to yield results faster than blood cultures (BC). We analyzed the clinical impact of a commercially available multiplex PCR system in patients with suspected sepsis.

Methods

Blood samples from patients with presumed sepsis were cultured with the Bactec 9240™ system (Becton Dickinson, Heidelberg, Germany) and aliquots subjected to analysis with the LightCycler® SeptiFast® (SF) Test (Roche Diagnostics, Mannheim, Germany) at a tertiary care centre. For samples with PCR-detected pathogens, the actual impact on clinical management was determined by chart review. Furthermore a comparison between the time to a positive blood culture result and the SF result, based on a fictive assumption that it was done either on a once or twice daily basis, was made.

Results

Of 101 blood samples from 77 patients, 63 (62%) yielded concordant negative results, 14 (13%) concordant positive and 9 (9%) were BC positive only. In 14 (13%) samples pathogens were detected by SF only, resulting in adjustment of antibiotic therapy in 5 patients (7,7% of patients). In 3 samples a treatment adjustment would have been made earlier resulting in a total of 8 adjustments in all 101 samples (8%).

Conclusion

The addition of multiplex PCR to conventional blood cultures had a relevant impact on clinical management for a subset of patients with presumed sepsis.