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Incremental value of multiplex real-time PCR for the early diagnosis of sepsis in the emergency department

Standard

Incremental value of multiplex real-time PCR for the early diagnosis of sepsis in the emergency department. / Schaub, Nora; Boldanova, Tujana; Noveanu, Markus; Arenja, Nisha; Hermann, Heinz; Twerenbold, Raphael; Frei, Reno; Bingisser, Roland; Trampuz, Andrej; Mueller, Christian.

In: SWISS MED WKLY, Vol. 144, 04.02.2014, p. w13911.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Schaub, N, Boldanova, T, Noveanu, M, Arenja, N, Hermann, H, Twerenbold, R, Frei, R, Bingisser, R, Trampuz, A & Mueller, C 2014, 'Incremental value of multiplex real-time PCR for the early diagnosis of sepsis in the emergency department', SWISS MED WKLY, vol. 144, pp. w13911. https://doi.org/10.4414/smw.2014.13911

APA

Schaub, N., Boldanova, T., Noveanu, M., Arenja, N., Hermann, H., Twerenbold, R., Frei, R., Bingisser, R., Trampuz, A., & Mueller, C. (2014). Incremental value of multiplex real-time PCR for the early diagnosis of sepsis in the emergency department. SWISS MED WKLY, 144, w13911. https://doi.org/10.4414/smw.2014.13911

Vancouver

Schaub N, Boldanova T, Noveanu M, Arenja N, Hermann H, Twerenbold R et al. Incremental value of multiplex real-time PCR for the early diagnosis of sepsis in the emergency department. SWISS MED WKLY. 2014 Feb 4;144:w13911. https://doi.org/10.4414/smw.2014.13911

Bibtex

@article{61b7d8008a904f8e9fe142465fd0cf2a,
title = "Incremental value of multiplex real-time PCR for the early diagnosis of sepsis in the emergency department",
abstract = "BACKGROUND: Delayed recognition of sepsis and inappropriate initial antibiotic therapy are associated with increased mortality and morbidity. The early detection of the causative organism in sepsis is an unmet clinical need. A novel multiplex real-time polymerase chain reaction (MRT-PCR) (SeptiFast{\textregistered}) technique may provide the microbiological diagnosis within six hours.METHODS: We assessed the diagnostic accuracy of blood cultures and MRT-PCR in a comparative diagnostic cohort study in 110 consecutive adult patients presenting to the emergency department (ED) with suspected sepsis.RESULTS: We collected 205 corresponding PCR samples and blood culture (BC) pairs from the 110 patients. There was moderate to high concordance between PCR and BC with 181 (88%) matching and 24 (12%) mismatching samples. The diagnostic accuracy of MRT-PCR in detecting sepsis and its causative organism was comparable to that of BCs. The additional use of MRT-PCR significantly reduced the time to microbiological diagnosis as compared to the use of conventional microbiological methods alone (mean time gained 3.9 hours, range 0-66 hours, p <0.001).CONCLUSION: Diagnostic accuracy of BCs and MRT-PCR in the early diagnosis of sepsis and its causative organism in the ED are comparable. However, MRT-PCR reduces the time to microbiological diagnosis. Whether a more rapid detection of the organism by MRT-PCR could improve the outcome of patients has to be assessed in large prospective randomised trials.",
keywords = "Aged, Bacteremia/blood, Blood/microbiology, Blood Chemical Analysis, DNA, Bacterial/analysis, DNA, Fungal/analysis, Early Diagnosis, Emergency Service, Hospital, Female, Fungemia/blood, Humans, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Real-Time Polymerase Chain Reaction, Single-Blind Method, Time Factors",
author = "Nora Schaub and Tujana Boldanova and Markus Noveanu and Nisha Arenja and Heinz Hermann and Raphael Twerenbold and Reno Frei and Roland Bingisser and Andrej Trampuz and Christian Mueller",
year = "2014",
month = feb,
day = "4",
doi = "10.4414/smw.2014.13911",
language = "English",
volume = "144",
pages = "w13911",
journal = "SWISS MED WKLY",
issn = "1424-7860",
publisher = "EMH Swiss Medical Publishers Ltd.",

}

RIS

TY - JOUR

T1 - Incremental value of multiplex real-time PCR for the early diagnosis of sepsis in the emergency department

AU - Schaub, Nora

AU - Boldanova, Tujana

AU - Noveanu, Markus

AU - Arenja, Nisha

AU - Hermann, Heinz

AU - Twerenbold, Raphael

AU - Frei, Reno

AU - Bingisser, Roland

AU - Trampuz, Andrej

AU - Mueller, Christian

PY - 2014/2/4

Y1 - 2014/2/4

N2 - BACKGROUND: Delayed recognition of sepsis and inappropriate initial antibiotic therapy are associated with increased mortality and morbidity. The early detection of the causative organism in sepsis is an unmet clinical need. A novel multiplex real-time polymerase chain reaction (MRT-PCR) (SeptiFast®) technique may provide the microbiological diagnosis within six hours.METHODS: We assessed the diagnostic accuracy of blood cultures and MRT-PCR in a comparative diagnostic cohort study in 110 consecutive adult patients presenting to the emergency department (ED) with suspected sepsis.RESULTS: We collected 205 corresponding PCR samples and blood culture (BC) pairs from the 110 patients. There was moderate to high concordance between PCR and BC with 181 (88%) matching and 24 (12%) mismatching samples. The diagnostic accuracy of MRT-PCR in detecting sepsis and its causative organism was comparable to that of BCs. The additional use of MRT-PCR significantly reduced the time to microbiological diagnosis as compared to the use of conventional microbiological methods alone (mean time gained 3.9 hours, range 0-66 hours, p <0.001).CONCLUSION: Diagnostic accuracy of BCs and MRT-PCR in the early diagnosis of sepsis and its causative organism in the ED are comparable. However, MRT-PCR reduces the time to microbiological diagnosis. Whether a more rapid detection of the organism by MRT-PCR could improve the outcome of patients has to be assessed in large prospective randomised trials.

AB - BACKGROUND: Delayed recognition of sepsis and inappropriate initial antibiotic therapy are associated with increased mortality and morbidity. The early detection of the causative organism in sepsis is an unmet clinical need. A novel multiplex real-time polymerase chain reaction (MRT-PCR) (SeptiFast®) technique may provide the microbiological diagnosis within six hours.METHODS: We assessed the diagnostic accuracy of blood cultures and MRT-PCR in a comparative diagnostic cohort study in 110 consecutive adult patients presenting to the emergency department (ED) with suspected sepsis.RESULTS: We collected 205 corresponding PCR samples and blood culture (BC) pairs from the 110 patients. There was moderate to high concordance between PCR and BC with 181 (88%) matching and 24 (12%) mismatching samples. The diagnostic accuracy of MRT-PCR in detecting sepsis and its causative organism was comparable to that of BCs. The additional use of MRT-PCR significantly reduced the time to microbiological diagnosis as compared to the use of conventional microbiological methods alone (mean time gained 3.9 hours, range 0-66 hours, p <0.001).CONCLUSION: Diagnostic accuracy of BCs and MRT-PCR in the early diagnosis of sepsis and its causative organism in the ED are comparable. However, MRT-PCR reduces the time to microbiological diagnosis. Whether a more rapid detection of the organism by MRT-PCR could improve the outcome of patients has to be assessed in large prospective randomised trials.

KW - Aged

KW - Bacteremia/blood

KW - Blood/microbiology

KW - Blood Chemical Analysis

KW - DNA, Bacterial/analysis

KW - DNA, Fungal/analysis

KW - Early Diagnosis

KW - Emergency Service, Hospital

KW - Female

KW - Fungemia/blood

KW - Humans

KW - Male

KW - Middle Aged

KW - Predictive Value of Tests

KW - Prospective Studies

KW - Real-Time Polymerase Chain Reaction

KW - Single-Blind Method

KW - Time Factors

U2 - 10.4414/smw.2014.13911

DO - 10.4414/smw.2014.13911

M3 - SCORING: Journal article

C2 - 24496744

VL - 144

SP - w13911

JO - SWISS MED WKLY

JF - SWISS MED WKLY

SN - 1424-7860

ER -