Broad-Range 16S rRNA Gene Polymerase Chain Reaction for Diagnosis of Culture-Negative Bacterial Infections

Rampini, S; Bloemberg, Guido V.; Keller, Peter M.; Büchler, Andrea; Dollenmaier, Günter; Speck, Roberto F.; Böttger, Erik C.

doi:10.1093/cid/cir692

Cited by 179 publications

(144 citation statements)

References 31 publications

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“…The relatively low incidence rate in this study might be explained by following reasons. One probable reason might be the low number and incorrect timing of blood cultures, which may have a significant effect on diagnostic of BSIs (Rampini et al, 2011;Schmitz et al, 2013). Another reason might be the small proportion of surgical and critically ill patients in our hospital.…”

Section: Discussionmentioning

confidence: 98%

Epidemiology and microbiology of nosocomial bloodstream infections: analysis of 482 cases from a retrospective surveillance study

Gan

Zhu

et al. 2015

J. Zhejiang Univ. Sci. B

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Abstract:In many traditional Chinese medicine (TCM) hospitals, most patients are elderly with chronic diseases. Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality. A retrospective surveillance study was performed to examine the epidemiology and microbiology of nBSIs in a TCM hospital from 2009 to 2011. A total of 482 patients with nBSIs were included in the study period. The incidence rate was 5.7/1000 admissions. Escherichia coli (25.5%) was the most common Gram-negative and coagulase-negative staphylococcus (CoNS) (14.1%) was the most common Gram-positive organism isolated. One-third of the E. coli and Klebsiella pneumoniae isolated from the nBSIs were the third-generation cephalosporin-resistant. Half of the Acinetobacter species isolates were resistant to imipenem. Of all the CoNS isolates, 90.7% were resistant to methicillin. Carbapenems and glycopeptide were the most frequently used for nBSI therapy. Only about one-third of patients (157/482) received appropriate empirical therapy. Septic shock, hemodialysis, Pitt bacteremia score >4, urinary tract infection, and appropriate empirical therapy were most strongly associated with 28-d mortality. The incidence of nBSIs was low in the TCM hospital but the proportion of nBSIs due to antibiotic-resistant organisms was high. A high Pitt bacteremia score was one of the most important risk factors for mortality in nBSIs. Therefore, the implementation of appropriate empirical therapy is crucial to improve the clinical outcome of nBSIs.

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Section: Discussionmentioning

confidence: 98%

Epidemiology and microbiology of nosocomial bloodstream infections: analysis of 482 cases from a retrospective surveillance study

Gan

Zhu

et al. 2015

J. Zhejiang Univ. Sci. B

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“…Data of isolated microorganisms were derived from blood cultures, broad-range polymerase chain reaction [15,16] performed on postoperative valve material as well as from serological testing. If more than one type of microorganism had been isolated, the most likely IE causing organism was determined by an infectious disease specialist.…”

Section: Microbiology Datamentioning

confidence: 99%

Early versus late initial echocardiographic assessment in infective endocarditis: similar findings and no difference in clinical outcome

2013

Cardiovasc Med

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SummaryBackground: The optimal timing of the initial echocardiographic assessment and the influence of microorganisms on echocardiographic findings in patients with infective endocarditis (IE) are not well studied.Methods: In 274 patients with IE, we studied the impact of antibiotic treatment duration of ≤2 days (early, 119 patients) or >2 days (late, 144 patients) prior to diagnostic echocardiography on IE specific findings and on clinical outcomes. Results were stratified for patients with Staphylococcus aureus (SA patients, n = 84) and those with other causative organisms (non-SA patients, n = 190).Results: There were no differences on specific echocardiographic findings between patients with early versus late echocardiography: Presence of vegetations: 91% vs 86%, p = 0.25; size of vegetations: 1.5 ± 0.7 cm vs 1.5 ± 0.8 cm, p = 0.83; paravalvular abscess: 24% vs 24%, p = 0.88, or valve destruction: 44% vs 35%, p = 0.17. There were also no differences in terms of clinical outcomes between the two groups: Heart surgery for IE in 61% vs 53%, p = 0.21, and in-hospital death in 8% vs 11%, p = 0.46. The presence of SA was not associated with specific findings on echocardiography or worse clinical outcomes compared to non-SA patients.Conclusions: In patients with infective endocarditis, the findings of early vs late initial echocardiographic a ssessment did not differ, and echocardiographic findings did not allow inference on the causing organism. Neither the timing of the initial echocardiographic study nor any organism involved was associated with clinical outcome.

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“…An increased availability of rapid diagnostic methods to determine if an infection is of viral or bacterial nature 12,31,34,35 would help to reduce the inadequate use of empiric antibiotics and establish an adequate therapy earlier.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of a program to improve antibiotic use in children hospitalized in a children’s tertiary care facility in Argentina

2014

Arch Argent Pediat

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Introduction.Inadequate antibiotic use is associated with an increased emergence of resistant microorganisms, higher morbidity and mortality rates, and an impact on public health. Objective. To assess the effectiveness of a program aimed at improving the use of antimicrobials in patients hospitalized at Hospital Garrahan. Material and Methods. Prospective, longitudinal, before and after study with no control group. Study period: From November 1 st , 2010 to June 30 th , 2011. Patients receiving parenteral antibiotics were included. Newborn infants, burned patients and those receiving prophylactic antibiotics were excluded. The periods before and after implementing discussion and monitoring workshops for antibiotic prescription and distributing treatment guidelines were compared. An univariate analysis and a multiple logistic regression study were performed (STATA 8.0). Results. In the pre-intervention period, 376 patients were included; of them, 35.6% had received inadequate treatment. The multiple regression analysis showed that the endpoints for inadequate antibiotic use were acute lower respiratory tract infection (OR: 3.80; 95% CI: 1.35-3.26; p = 0.04), fever without a source in hospitalized patients (OR: 5.55; 95% CI: 2.43-12.6; p < 0.01), and febrile neutropenia (OR: 0.29; 95% CI: 0.10-0.7; p < 0.01). In the post-intervention period, 357 patients were included; 21.5% had received inadequate treatment. A reduction in inadequate antibiotic prescription was observed compared to the pre-intervention period (p < 0.01). The multiple regression analysis showed that endpoints for inadequate use were skin and soft tissue infections (OR: 0.33; 95% CI: 0.13-0.93; p = 0.035), and febrile neutropenia (OR: 0.48; 95% CI: 0.22-0.94; p= 0.04). Conclusion. The program was effective and allowed to improve antibiotic prescription practices in hospitalized children.

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Broad-Range 16S rRNA Gene Polymerase Chain Reaction for Diagnosis of Culture-Negative Bacterial Infections

Abstract: This study defines the role of 16S rRNA gene PCR for diagnosis of culture-negative bacterial infections. Our data show that 16S rRNA gene PCR is particularly useful for identification of bacterial pathogens in patients pretreated with antibiotics.

Cited by 179 publications

References 31 publications

Epidemiology and microbiology of nosocomial bloodstream infections: analysis of 482 cases from a retrospective surveillance study

Epidemiology and microbiology of nosocomial bloodstream infections: analysis of 482 cases from a retrospective surveillance study

Early versus late initial echocardiographic assessment in infective endocarditis: similar findings and no difference in clinical outcome

Effectiveness of a program to improve antibiotic use in children hospitalized in a children’s tertiary care facility in Argentina

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