• David C Kasper, Ipek Altiok, Thomas P Mechtler, Judith Böhm, Julia Straub, Michaela Langgartner, Arnold Pollak, Kurt R Herkner, and Angelika Berger.
• Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
• Neonatology. 2013 Jan 1;103(4):268-73.

BackgroundConventional blood culture is still the gold standard for sepsis diagnosis but results are not immediately available and pathogens are only detected in approximately 25% of cases. New molecular assays for the detection of blood stream pathogens are promising diagnostic tools.ObjectivesThe aim of the study was to adapt and evaluate a multiplex PCR system using 100 µl blood. -Methods46 blood specimens of very low birth weight infants (818 ± 242 g) with suspected sepsis were analyzed using the Roche SeptiFast MGRADE PCR with a modified DNA extraction protocol and software handling tool for decreased blood volume requirements.ResultsIn the non-infected group, 5/21 infants had a positive PCR result with coagulase-negative staphylococci. All pathogens detected in the blood culture positive group (n = 15) were also detected by PCR. In addition, 4/6 patients had a positive PCR result in the clinical sepsis group (clinical and laboratory signs of sepsis but negative blood culture). Overall, the PCR was demonstrated to have a higher sensitivity (90.5%; 95%CI 68.2-98.3%) in comparison to blood culture (71.4%; 95%CI 47.7-87.8%) including clinical sepsis cases, even though it had a lower specificity (80.0%; 95%CI 58.7-92.4% versus 100.0%; 95%CI 83.4-100.0%).ConclusionsThese first data demonstrate the usability and potential benefit of this multiplex PCR using a modified DNA extraction for the rapid detection of nosocomial sepsis in preterm infants in addition to blood culture.Copyright © 2013 S. Karger AG, Basel.

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