Evaluation of the Broad-Range PCR/ESI-MS Technology in Blood Specimens for the Molecular Diagnosis of Bloodstream Infections
Jordana-Lluch, Elena (Universitat Autònoma de Barcelona. Departament de Genètica i de Microbiologia)
Giménez, Montserrat (Universitat Autònoma de Barcelona. Departament de Genètica i de Microbiologia)
Quesada, María Dolores (Universitat Autònoma de Barcelona. Departament de Genètica i de Microbiologia)
Rivaya, Belén (Universitat Autònoma de Barcelona. Departament de Genètica i de Microbiologia)
Marcó, Clara (Universitat Autònoma de Barcelona. Departament de Genètica i de Microbiologia)
Domínguez, María Jesús (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Arméstar, Fernando (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Martró, Elisa (Universitat Autònoma de Barcelona. Departament de Genètica i de Microbiologia)
Ausina, Vicente (Universitat Autònoma de Barcelona. Departament de Genètica i de Microbiologia)

Date:	2015
Abstract:	Rapid identification of the etiological agent in bloodstream infections is of vital importance for the early administration of the most appropriate antibiotic therapy. Molecular methods may offer an advantage to current culture-based microbiological diagnosis. The goal of this study was to evaluate the performance of IRIDICA, a platform based on universal genetic amplification followed by mass spectrometry (PCR/ESI-MS) for the molecular diagnosis of sepsis-related pathogens directly from the patient's blood. A total of 410 whole blood specimens from patients admitted to Emergency Room (ER) and Intensive Care Unit (ICU) with clinical suspicion of sepsis were tested with the IRIDICA BAC BSI Assay (broad identification of bacteria and Candida spp. ). Microorganisms grown in culture and detected by IRIDICA were compared considering blood culture as gold standard. When discrepancies were found, clinical records and results from other cultures were taken into consideration (clinical infection criterion). The overall positive and negative agreement of IRIDICA with blood culture in the analysis by specimen was 74. 8% and 78. 6%, respectively, rising to 76. 9% and 87. 2% respectively, when compared with the clinical infection criterion. Interestingly, IRIDICA detected 41 clinically significant microorganisms missed by culture, most of them from patients under antimicrobial treatment. Of special interest were the detections of one Mycoplasma hominis and two Mycobacterium simiae in immunocompromised patients. When ICU patients were analyzed separately, sensitivity, specificity, positive and negative predictive values compared with blood culture were 83. 3%, 78. 6%, 33. 9% and 97. 3% respectively, and 90. 5%, 87. 2%, 64. 4% and 97. 3% respectively, in comparison with the clinical infection criterion. IRIDICA is a promising technology that offers an early and reliable identification of a wide variety of pathogens directly from the patient's blood within 6h, which brings the opportunity to improve management of septic patients, especially for those critically ill admitted to the ICU.
Grants:	Ministerio de Economía y Competitividad MS09/00044
Note:	Altres ajuts: PTA2011-5619-T del Ministerio de Ciencia e Innovación (MICINN), del Plan Nacional de Investigación científica, Desarrollo e Innovación Tecnológica (I+D+I) i de la Sociedad Española de Enfermedades Infecciosas y de Microbiología
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	PloS one, Vol. 10 Núm. 10 (october 2015) , ISSN 1932-6203

DOI: 10.1371/journal.pone.0140865
PMID: 26474394

13 p, 376.6 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles