Evaluation of the Magicplex™ Sepsis Real-Time Test for the Rapid Diagnosis of Bloodstream Infections in Adults
Evaluation of the Magicplex™ Sepsis Real-Time Test for the Rapid Diagnosis of Bloodstream Infections in Adults
复制标题
Magicplex™ 脓毒症实时检测对成人血流感染快速诊断的评估
DOI：
10.3389/fcimb.2019.00056
复制
发表时间：
2019
影响因子：
5.7
通讯作者：
J. Vila
中科院分区：
文献类型：
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作者：
Y. Zboromyrska;C. Cillóniz;N. Cobos;M. Almela;J. Hurtado;A. Vergara;C. Mata;Á. Soriano;J. Mensa;F. Marco;J. Vila
败血症是世界范围内一种严重的健康状况，每年影响全球3000多万人。血培养（BC）通常用于诊断败血症，因为在这种感染过程中血液中出现的微生物数量很少。然而，约50%的血液感染（BSI）呈阴性BC，这一数字在败血症中更高，这延迟了适当抗菌治疗的开始。这项前瞻性研究评估了一种多重实时聚合酶链反应，MagicplexTM脓毒症试验（MP），用于检测全血中的病原体，并将其与常规BC进行比较。我们分析了来自636名成年患者的809份血液样本，其中132/809（16.3%）的样本根据BC和/或MP呈一种或多种相关微生物阳性。MP的敏感性和特异性分别为29%和95%，而BC和MP的一致性水平为87%。BC的污染率（10%）高于MP (4.8%) （P < 0.001）。只有mp阳性样本的患者比只有bc阳性样本的患者更有可能接受抗菌治疗（47%）（P = 0.002）。总之，MP测试在某些临床环境中是有用的，例如在接受抗生素治疗的患者中。然而，低灵敏度证明了其作为常规诊断算法的一部分的使用。
Sepsis is a serious health condition worldwide, affecting more than 30 million people globally each year. Blood culture (BC) is generally used to diagnose sepsis because of the low quantity of microbes occurring in the blood during such infections. However, ~50% of bloodstream infections (BSI) give negative BC, this figure being higher for sepsis, which delays the start of appropriate antimicrobial therapy. This prospective study evaluated a multiplex real-time polymerase chain reaction, the MagicplexTM Sepsis test (MP), for the detection of pathogens from whole blood, comparing it to routine BC. We analyzed 809 blood samples from 636 adult patients, with 132/809 (16.3%) of the samples positive for one or more relevant microorganism according to BC and/or MP. The sensitivity and specificity of MP were 29 and 95%, respectively, while the level of agreement between BC and MP was 87%. The rate of contaminated samples was higher for BC (10%) than MP (4.8%) (P < 0.001). Patients with only MP-positive samples were more likely to be on antimicrobial treatment (47%) than those with only BC-positive samples (18%) (P = 0.002). In summary, the MP test could be useful in some clinical setting, such as among patients on antibiotic therapy. Nevertheless, a low sensitivity demonstrated impairs its use as a part of a routine diagnostic algorithm.