1029. Usefulness of Multiplex blood PCR in combination with blood cultures for improvement of pathogen detection in sepsis
Session: Poster Abstract Session: Diagnosis of Bloodstream / Cardiovascular Infections
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • sepsis_pcr[1].pdf (219.6 kB)
  • Background: Sepsis is still a serious medical condition that requires rapidly identification of pathogens and appropriate antibiotic treatment. Although the current gold standard for detection of pathogens in sepsis patients is blood cultures, it takes three or more days for pathogens identification and antimicrobial susceptibility testing. In this study, we performed a prospective study to evaluate the diagnostic accuracy and clinical utility of SeptiFast (SF) system, a commercially available molecular based test system, in the clinical setting to support early diagnosis of sepsis.

    Methods: A total of 44 patients, suspected of having systemic inflammatory response syndrome (SIRS) caused by bacterial or fungal infection, were enrolled in this study from Jan to Dec 2009. From them, 88 blood samples were taken and blood culture was performed to identify pathogens. Whole blood (44) was also collected aseptically for DNA Detection Kit analysis immediately after its collection for blood culture. The results of the DNA Detection Kit, blood culture and other culture tests were compared.

    Results: Twenty-three (52.3 %) and 15 (34.1 %) of the 44 samples under study tested positive by blood culture and SF, respectively. Contrary to previous method, blood culture analysis detected more bacteria compared with SF system among antibiotic pre-treated patients(26.1 % (6/23) vs 6.7% (1/15)). Contaminants such as CoNS were more frequently isolated among blood cultures compared to SF. Six pathogens were detected by blood culture only; conversely, this system missed 1 episode of Klebsiella bacteremia Time to positivitiy in blood culture was 86.4 ± 33.0 (49~192hr), however, the result of SF were available in about 4.5 hours.

    Conclusion: In our study, SeptiFast Test was not superior in comparision with blood culture, though it offered an improved time to detect pathogens. So this rapid multiplex pathogen system complemented traditional blood culture method. Adequately designed intervention studies are needed to prove its clinical effectiveness in improving appropriate antibiotic selection and patient outcomes


    Subject Category: D. Diagnostic microbiology

    Jin-Won Chung1, Seong-Ho Choi, M. D. 1, Sun Young Cho, M.D.1 and Mi Kyung Lee, M.D.2, (1)Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea, (2)Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, South Korea

    Disclosures:

    J. W. Chung, None

    S. H. Choi, None

    S. Y. Cho, M.D., None

    M. K. Lee, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.