Evaluation of the SEPTIFAST real-time PCR for rapid identification of blood pathogens in patients with suspected sepsis: an experience in a northwestern Italy hospital

Ref ID: 17699

Author:

E. Burdino*, M. Milia, R. Milano, G. Gregori, T. Allice, T. Ruggiero,
M. Borella, E. Scuccimarra, V. Ghisetti

Author address:

Turin, IT)

Full conference title:

22nd European Congress of Clinical Microbiology and Infectious Diseases

Abstract:

Objective: Sepsis is a serious medical condition that requires rapidly
administered appropriate antibiotic treatment.
Although blood culture (BC) remains the gold standard for bloodstream
infections (BSI) diagnosis, because it allows the execution of antibiotics
sensitivity tests, it often lacks sensitivity, especially in patients already
treated with antibiotics.
Molecular diagnostic tools can contribute to a more rapid diagnosis in
septic patients.
Aim of the present study was to investigate the potential clinical utility
of SeptiFast LightCycler (SF) in patients with suspected sepsis,
admitted to departments of Infectious Diseases, Amedeo di Savoia
Hospital University of Turin from January 2009 to June 2011.
Methods: Five hundred thirty-six samples collected from patients with
clinically suspected sepsis were analyzed, sampling on the same day, by
SF real-time PCR (Roche Diagnostics, Germany) and by BC
(automated Bact/Alert 3D BioMe’rieux). The results were compared in
terms of positive identifications obtained individually and in
combination.
SF method is able to the detect DNA of 25 of the most frequent
bacterial and fungal pathogens from whole blood samples in <6 hours. Results: 19.8% of the samples resulted positive to SF while 16.1% to BC (v2 = 154.71, p < 0.0001); two isolates were detected only by BC and identified as a species not included in SF master list (N. meningitidis and C. neoformans). The difference between the two percentage were further increased if contaminants were excluded: while the rate of SF contamination is almost undetectable (2/534), the BC contamination rate (19/534) is 3.5%. The positivity rate of combined methods was 25.9%, allowing detection of 19 etiologic agents in monomicrobial and nine in polymicrobial infections (SF = 9, BC = 4). The analysis of concordance showed a overall agreement between the two methods equal to 85.6%. Considering fungal infections, two samples were founded positive to Aspergillus fumigatus only by SF. SF results were obtained in <6 hours and BC, assessed on Gram staining evaluation, in an average of 3 days. Conclusions: Our results show that SF method reduces time of pathogens detection and increases microbial identification in patients with clinical suspected sepsis. SF can be considered as a complementary test to BC in the management of critically ill patients.

Abstract Number: P1796

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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