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

TY - JOUR

T1 - Comparison of three different commercial PCR assays for the detection of pathogens in critically ill sepsis patients

AU - Schreiber, J

AU - Nierhaus, A

AU - Braune, S A

AU - Heer, Geraldine

AU - Kluge, S

PY - 2013

Y1 - 2013

N2 - 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.

AB - 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.

KW - Aged

KW - Anti-Bacterial Agents

KW - Bacterial Infections

KW - Bacteriological Techniques

KW - Blood

KW - Critical Care

KW - Female

KW - Germany

KW - Humans

KW - Male

KW - Middle Aged

KW - Multiplex Polymerase Chain Reaction

KW - Polymerase Chain Reaction

KW - Predictive Value of Tests

KW - Prospective Studies

KW - Sepsis

U2 - 10.1007/s00063-013-0227-1

DO - 10.1007/s00063-013-0227-1

M3 - SCORING: Journal article

C2 - 23516029

VL - 108

SP - 311

EP - 318

JO - MED KLIN-INTENSIVMED

JF - MED KLIN-INTENSIVMED

SN - 2193-6218

IS - 4

M1 - 4

ER -