For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
12
views
18
references
 Top references
cited by
6
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      82
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Evaluation of Real-Time PCR Coupled With Multiplex Probe Melting Curve Analysis for Pathogen Detection in Patients With Suspected Bloodstream Infections

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background: This study aimed to evaluate real-time polymerase chain reaction coupled with multiplex probe melting curve analysis (PCR-MCA) for pathogen detection in patients with suspected bloodstream infections (BSIs).

          Methods: A PCR-MCA assay was developed for simultaneous identification of 28 kinds of the most common pathogens and two resistance genes within a few hours. The diagnostic performance of the PCR-MCA assay was determined and compared to the results of blood culture.

          Results: A total of 2,844 consecutive new episodes of suspected BSIs in 2,763 patients were included in this study. There were 269 episodes of pathogens identified by blood culture. For all the pathogens tested, the PCR-MCA assay exhibited a sensitivity of 88.8% (239/269), specificity of 100% (2,575/2,575), and agreement of 98.9% (2,814/2,844). For the pathogens on the PCR-MCA list, the PCR-MCA results had a sensitivity of 99.2% (239/241), specificity of 100% (2,575/2,575), and agreement of 99.9% (2,814/2,816) compared with the results of blood culture. For seven samples with multiple pathogens identified simultaneously during one blood culture investigation, the PCR-MCA assay verified the results of the blood culture, with an agreement rate of 100% for each.

          Conclusion: The PCR-MCA assay could discover 88.8% of the pathogens in clinical practice, showing excellent diagnostic performance vs. that of blood culture for pathogen detection in patients with suspected BSIs, and would contribute to rapid diagnosis and correct antibiotic administration.

          Related collections

          Most cited references18

          • Record: found
          • Abstract: found
          • Article: not found

          New developments in the diagnosis of bloodstream infections.

          S. Danner, Odile van den Heuvel, Christina M. J. E. Vandenbroucke-Grauls … (2004)
          New techniques have emerged for the detection of bacteria in blood, because the blood culture as gold standard is slow and insufficiently sensitive when the patient has previously received antibiotics or in the presence of fastidious organisms. DNA-based techniques, hybridisation probes, and PCR-based detection or protein-based detection by mass spectroscopy are aimed at rapid identification of bacteria and provide results within 2 h after the first signal of growth in conventional blood cultures. Also, detection of microorganisms directly in blood by pathogen-specific or broad-range PCR assays (eubacterial or panfungal) shows promising results. Interpretation is complex, however, because of detection of DNA rather than living pathogens, the risk of interfering contamination, the presence of background DNA in blood, and the lack of a gold standard. As these techniques are emerging, clinical value and cost-effectiveness have to be assessed. Nevertheless, molecular assays are expected eventually to replace the current conventional microbiological techniques for detection of bloodstream infections.
          Article 0 comments Cited 100 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Microbial diagnosis of bloodstream infection: towards molecular diagnosis directly from blood.

            O. Opota, K Jaton, G Greub (2015)
            When a bloodstream infection (BSI) is suspected, most of the laboratory results-biochemical and haematologic-are available within the first hours after hospital admission of the patient. This is not the case for diagnostic microbiology, which generally takes a longer time because blood culture, which is to date the reference standard for the documentation of the BSI microbial agents, relies on bacterial or fungal growth. The microbial diagnosis of BSI directly from blood has been proposed to speed the determination of the etiological agent but was limited by the very low number of circulating microbes during these paucibacterial infections. Thanks to recent advances in molecular biology, including the improvement of nucleic acid extraction and amplification, several PCR-based methods for the diagnosis of BSI directly from whole blood have emerged. In the present review, we discuss the advantages and limitations of these new molecular approaches, which at best complement the culture-based diagnosis of BSI.
            Article 0 comments Cited 87 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Bloodstream infections in neutropenic cancer patients: A practical update.

              Giulia Gustinetti, Malgorzata Mikulska (2016)
              Bloodstream infections (BSI) are among the most frequent complications in neutropenic cancer patients and, if caused by Gram-negative rods, are associated with high mortality. Thus, fever during neutropenia warrants prompt empirical antibiotic therapy which should be active against the most frequent Gram-negatives. In the last decade, there has been a worldwide increase in multidrug resistant (MDR) strains. In these cases, the traditional choices such as oral therapy, ceftazidime, cefepime, piperacillin-tazobactam, or even carbapenems, might be ineffective. Therefore novel de-escalation approach has been proposed for patients who are at high risk for infections due to MDR bacteria. It consists of starting antibiotics which cover the most probable resistant strain but it is narrowed down after 72 hours if no MDR pathogen is isolated. With increasing bacterial resistance, the benefit of fluoroquinolone prophylaxis during prolonged neutropenia remains to be confirmed. Antibiotic stewardship and infection control programs are mandatory in every cancer center.
              Article 0 comments Cited 71 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Cell Infect Microbiol
                Journal ID (iso-abbrev): Front Cell Infect Microbiol
                Journal ID (publisher-id): Front. Cell. Infect. Microbiol.
                Title: Frontiers in Cellular and Infection Microbiology
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2235-2988
                Publication date (Electronic): 22 October 2019
                Publication date Collection: 2019
                Volume: 9
                Electronic Location Identifier: 361
                Affiliations
                [1] 1Center of Clinical Laboratory, Zhongshan Hospital, School of Medicine, Xiamen University , Xiamen, China
                [2] 2Xiamen Hospital of Traditional Chinese Medicine , Xiamen, China
                [3] 3Shaoxing Center for Disease Control and Prevention , Shaoxing, China
                [4] 4Institute of Infectious Disease, School of Medicine, Xiamen University , Xiamen, China
                Author notes

                Edited by: Caspar Yvan, Centre Hospitalier Universitaire de Grenoble, France

                Reviewed by: Tam T. Van, Harbor–UCLA Medical Center, United States; Krisztina M. Papp-Wallace, Louis Stokes Cleveland VA Medical Center, United States; Vittorio Sambri, University of Bologna, Italy

                *Correspondence: Jian-Jun Niu niujianjun211@ 123456xmu.edu.cn

                This article was submitted to Clinical Microbiology, a section of the journal Frontiers in Cellular and Infection Microbiology

                †These authors have contributed equally to this work

                Article
                DOI: 10.3389/fcimb.2019.00361
                PMC ID: 6817478
                PubMed ID: 31696061
                SO-VID: 5ff356a4-28ea-44ae-864f-0e1f63dc662b
                Copyright © Copyright © 2019 Xiao, Shen, Zhao, Yao, Yang and Niu.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 08 July 2019
                Date accepted : 07 October 2019
                Page count
                Figures: 0, Tables: 5, Equations: 0, References: 21, Pages: 11, Words: 7589
                Categories
                Subject: Cellular and Infection Microbiology
                Subject: Original Research

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: pcr-mca,bloodstream infections,pathogen detection,diagnostic performance,blood culture
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: pcr-mca, bloodstream infections, pathogen detection, diagnostic performance, blood culture

                Comments

                Comment on this article

                scite_

                Similar content82

                See all similar

                Cited by6

                See all cited by

                Most referenced authors482

                See all reference authors