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The Journal of infection · Feb 2017
Observational StudyMolecular 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, and Vicente Ausina.
- Microbiology Service, Germans Trias i Pujol University Hospital, Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain; CIBER in Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
- J. Infect. 2017 Feb 1; 74 (2): 187-194.
ObjectivesOnco-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.MethodsA 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.ResultsThe 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.ConclusionsPCR/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.Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
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