Molecular diagnosis of bloodstream infections in onco-haematology patients with PCR/ESI-MS technology

Elena Jordana-Lluch, Belén Rivaya, Clara Marcó, Montserrat Giménez, Mª Dolores Quesada, Agustín Escobedo, Montserrat Batlle, Elisa Martró, Vicente Ausina

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15 Citations (Scopus)

Abstract

© 2016 The British Infection Association Objectives Onco-haematological patients are prone to develop infections, and antibiotic prophylaxis may lead to negative blood cultures. Thus, the microbiological diagnosis and subsequent administration of a targeted antimicrobial therapy is often difficult. The goal of this study was to evaluate the usefulness of IRIDICA (PCR/ESI-MS technology) for the molecular diagnosis of bloodstream infections in this patient group. Methods A total of 463 whole blood specimens from different sepsis episodes in 429 patients were analysed using the PCR/ESI-MS platform, comparing the results with those of blood culture and other clinically relevant information. Results The sensitivity of PCR/ESI-MS by specimen (excluding polymicrobial infections, n = 25) in comparison with blood culture was 64.3% overall, 69.0% in oncological patients, and 59.3% in haematological patients. When comparing with a clinical infection criterion, overall sensitivity rose to 74.7%, being higher in oncological patients (80.0%) than in haematological patients (67.7%). Thirty-one microorganisms isolated by culture were not detected by IRIDICA, whereas 42 clinically relevant pathogens not isolated by culture were detected moleculary. Conclusions PCR/ESI-MS offers a reliable identification of pathogens directly from whole blood. While additional studies are needed to confirm our findings, the system showed a lower sensitivity in onco-haematological patients in comparison with previously reported results in patients from the Intensive Care Unit.
Original languageEnglish
Pages (from-to)187-194
JournalJournal of Infection
Volume74
Issue number2
DOIs
Publication statusPublished - 1 Feb 2017

Keywords

  • Bloodstream infection
  • Haematology
  • Molecular diagnosis
  • Oncology
  • PCR/ESI-MS

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