Prospective comparison of a PCR assay and a microbiological culture technique for identification of pathogens from blood and non-blood samples in septic patients.
Prospective comparison of a PCR assay and a microbiological culture technique for identification of pathogens from blood and non-blood samples in septic patients.
复制标题
DOI：
10.1186/s40560-015-0116-1
复制
发表时间：
2015
影响因子：
7.1
通讯作者：
Usichenko T
中科院分区：
文献类型：
--
作者：
Plettig R;Nowak A;Balau V;Hahnenkamp K;Usichenko T
分子扩增技术被认为是一种有用的辅助手段，在早期发现病原体在脓毒症患者。目的是研究聚合酶链反应（PCR）检测的可行性相比，标准的微生物培养（MC）技术在败血症患者的血液和非血液样本中的病原微生物鉴定。在54名脓毒症患者的发热脓毒症发作（SE）期间采集了用于病原体鉴定的样本，并使用MC和PCR进行分析。飞利浦医疗系统公司提供的半自动多重PCR能够检测9种不同的病原体。评价了使用PCR与MC进行病原体鉴定的准确性以及PCR对抗菌治疗潜在决策过程的省时效果。在87 SE期间采集的共计258份样本中，两种方法从非血液中产生的病原体多于血液样本（87% vs. 45%; p = 0.002）。PCR在血液样本中比MC鉴定出更多的病原体（98 vs. 21; p < 0.0001），但在其他体液中没有。在35例SE中，基于PCR结果的适当抗菌治疗的潜在决定可能比基于标准MC的决定早50小时（中位数;四分位数间距35-87）。在脓毒症患者中，多重PCR比标准MC技术鉴定出更多的从血液样品中分离的病原微生物。在非血液样本中，PCR与MC相当。本文的在线版本（doi：10.1186/s40560-015-0116-1）包含补充材料，可供授权用户使用。
Molecular amplification techniques are suggested to be a useful adjunct in early detection of pathogens in septic patients. The aim was to study the feasibility of a polymerase chain reaction (PCR) assay compared to the standard microbiological culture (MC) technique in identification of pathogenic microorganisms from blood and non-blood samples in septic patients. Samples for pathogen identification were taken during febrile septic episodes (SE) in 54 patients with sepsis and analyzed using both MC and PCR. Semi-automated multiplex PCR, provided by Philips Medical Systems, was able to detect nine different pathogens. The accuracy of pathogen identification using PCR vs. MC as well as the time-saving effect of PCR on the potential decision-making process for antimicrobial therapy was evaluated. In a total of 258 samples taken during 87 SE, both methods yielded more pathogens from the non-blood than blood samples (87 % vs. 45 %; p = 0.002). PCR identified more pathogens than MC in the blood samples (98 vs. 21; p < 0.0001), but not in other body fluids. In 35 SE, the potential decision on appropriate antimicrobial therapy based on PCR results could have been made 50 (median; interquartile range 35–87) hours earlier than decisions based on standard MC. In septic patients, multiplex PCR identified more pathogenic microorganisms isolated from the blood samples than the standard MC technique. In the non-blood samples, PCR was comparable to that of MC. The online version of this article (doi:10.1186/s40560-015-0116-1) contains supplementary material, which is available to authorized users.