• Anthony Dugard, Delphine Chainier, Olivier Barraud, Fabien Garnier, Marie-Cécile Ploy, Philippe Vignon, and Bruno François.
• Medical-Surgical Intensive Care Unit, CHU Dupuytren, Limoges, France.
• J Crit Care. 2012 Aug 1;27(4):416.e1-6.

PurposeThe purpose of this study is to evaluate the feasibility and interest of real-time polymerase chain reaction (RT-PCR) testing for bacterial genomes in body fluids other than blood in patients with acute severe sepsis.MethodsTwenty-six consecutive patients admitted for severe sepsis or septic shock were prospectively studied. Body fluids were sampled as clinically indicated and tested using standard microbiological methods and modified RT-PCR methods (universal PCR and specific PCRs). Results of standard microbiological tests were compared with those of PCR tests.ResultsDirect RT-PCR testing was successfully performed on all nonblood body fluids. Of 29 body fluids collected, 23 were positive for at least 1 microorganism with conventional tests. Of 18 microbiological tests positive for a single microorganism, 15 fully agreed with RT-PCR assays, and the remaining 3 samples were infected with bacteria not screened by PCR testing. Among the 5 polymicrobial results obtained with conventional tests, RT-PCR agreed in 4 patients. The RT-PCR tests allowed additional clinically relevant bacterial identification in 3 of 6 samples with negative microbiological culture.ConclusionsOur results indicate that direct PCR testing may improve the detection of bacteria in body fluids other than blood in patients with acute severe sepsis.Copyright © 2012 Elsevier Inc. All rights reserved.

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