Diagnosis of infective endocarditis: comparison of the LightCycler SeptiFast real-time PCR with blood culture

Mencacci, Antonella; Leli, Christian; Montagna, Paolo; Cardaccia, Angela; Meucci, Marta; Bietolini, Cristiana; Cenci, Elio; Pasticci, Maria Bruna; Bistoni, Francesco

doi:10.1099/jmm.0.040113-0

Cited by 18 publications

(12 citation statements)

References 16 publications

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“…Interestingly, all samples were from patients with bacterial endocarditis. This finding is in line with the notion that PCT does not increase significantly in patients with bacterial endocarditis, reaching median values of 0.21 ng/ml [30], and outlines the fact that SF can be successfully used for diagnosis of endocarditis [31].…”

Section: Discussionsupporting

confidence: 87%

Procalcitonin Predicts Real-Time PCR Results in Blood Samples from Patients with Suspected Sepsis

et al. 2012

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BackgroundEarly diagnosis and rapid bacterial identification are of primary importance for outcome of septic patients. SeptiFast® (SF) real-time PCR assay is of potential utility in the etiological diagnosis of sepsis, but it cannot replace blood culture (BC) for routine use in clinical laboratory. Procalcitonin (PCT) is a marker of sepsis and can predict bacteremia in septic patients. The aim of the present study was to investigate whether PCT serum levels could predict SF results, and could help screening febrile patients in which a SF assay can improve the etiological diagnosis of sepsis.MethodsFrom 1009 febrile patients with suspected sepsis, 1009 samples for BC, SF real-time PCR, and PCT determination were obtained simultaneously, and results were compared and statistically analysed. Receiver operating characteristic (ROC) curves were generated to determine the area under the curve and to identify which cut-off of PCT value produced the best sensitivity to detect SF results.ResultsMean PCT values of sera drawn simultaneously with samples SF positive (35.42±61.03 ng/ml) or BC positive (23.14±51.56 ng/ml) for a pathogen were statistically higher than those drawn simultaneously with SF negative (0.84±1.67 ng/ml) or BC negative (2.79±16.64 ng/ml) samples (p<0.0001). For SF, ROC analysis showed an area under the curve of 0.927 (95% confidence interval: 0.899–0.955, p<0.0001). The PCT cut-off value of 0.37 ng/ml showed a negative predictive value of 99%, reducing the number of SF assays of 53.9%, still identifying the 96.4% of the pathogens.ConclusionPCT can be used in febrile patients with suspected sepsis to predict SF positive or negative results. A cut-off value of 0.37 ng/ml can be considered for optimal sensitivity, so that, in the routine laboratory activity, SF assay should not be used for diagnosis of sepsis in an unselected patient population with a PCT value <0.37 ng/ml.

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Section: Discussionsupporting

confidence: 87%

Procalcitonin Predicts Real-Time PCR Results in Blood Samples from Patients with Suspected Sepsis

et al. 2012

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“…Nevertheless, Mencacci et al. suggest that SF may be a useful tool for the detection of endocarditis pathogens in patients undergoing antimicrobial therapy [41]. …”

Section: Discussionmentioning

confidence: 99%

SeptiFast versus blood culture in clinical routine – A report on 3 years experience

Korber

Zeller

Grünstäudl

et al. 2017

Wien Klin Wochenschr

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SummaryBackgroundIn recent years a multiplex real-time PCR (SeptiFast) has been introduced, allowing detection of 25 common blood pathogens considerably faster than conventional blood culture.MethodsSeptiFast was applied routinely in addition to blood culture in cases of critically ill patients with fever and other signs of severe systemic infections. In this study data of 470 episodes were retrospectively analysed to assess the impact of various parameters, such as clinical indications, assigning ward and antimicrobial treatment on test outcome using a multivariate logistic model.ResultsAfter exclusion of microorganisms classified as contaminants, the concordance between SeptiFast and blood culture was 85.5%. SeptiFast detected 98 out of 120, while blood culture merely found 63 out of 120 potential pathogens. In comparison to blood culture, SeptiFast showed considerably higher positivity rates in sepsis, pneumonia and febrile immunosuppression and a lower rate in endocarditis. The highest positivity and concordance between tests was shown in patients from the emergency room (P = 0.007).ConclusionsThe results obtained in this study are similar to those from prospective settings confirming the robustness of the SeptiFast assay in routine use. Our data suggest that SeptiFast is a valuable add-on to blood culture and may increase the diagnostic efficiency of a microbiological laboratory.

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“…In a study of 51 febrile intravenous drug users (IDUs), SepsiTest® was found to have 87% sensitivity and specificity for detecting microorganisms compared to blood culture, but showed perfect diagnostic performance in detecting pathogens in patients with infective endocarditis (66). In another similar study, SeptiFast® was found to be useful in the diagnosis of infective endocarditis, particularly in patients who had been pre-treated with antibiotics (67). …”

Section: Multiplex Technologies For Direct Diagnosis From Clinicalmentioning

confidence: 99%

“…Multiplex technologies have also been used in other types of microbial infections including bone and joint infections (64) and infectious endocarditis (65–67). In infectious endocarditis, patients can have negative blood culture results due to low pathogenic load in the blood, prior antimicrobial therapy, or the presence of fastidious microorganisms.…”

Section: Multiplex Technologies For Direct Diagnosis From Clinicalmentioning

confidence: 99%

Commercial Multiplex Technologies for the Microbiological Diagnosis of Sepsis

Lebovitz

Burbelo

2013

Mol Diagn Ther

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In patients with suspected sepsis, rapid and accurate diagnosis of the causative infectious agent is critical. Although clinicians often use empiric antimicrobial therapy until the blood cultures are available to potentially adjust treatment, this approach is often not optimum for patient care. Recently, several commercial molecular multiplex technologies have shown promise for fast and comprehensive diagnosis of microorganisms and their antimicrobial resistance signatures. While one class of multiplex technologies is directed at improving the speed and diagnostic information obtained from positive blood cultures, the other identifies the causative microorganisms directly from clinical blood samples. The goal of this review is to provide an overview of these molecular technologies and describe their performance capabilities compared to standard blood cultures and in some cases to each other. We discuss the current clinical impact, limitations, and likely futures advances these multiplex technologies may have in guiding the management of patients with sepsis.

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Diagnosis of infective endocarditis: comparison of the LightCycler SeptiFast real-time PCR with blood culture

Abstract: JMM CorrespondenceDiagnosis of infective endocarditis: comparison of the LightCycler SeptiFast real-time PCR with blood culture

Cited by 18 publications

References 16 publications

Procalcitonin Predicts Real-Time PCR Results in Blood Samples from Patients with Suspected Sepsis

Procalcitonin Predicts Real-Time PCR Results in Blood Samples from Patients with Suspected Sepsis

SeptiFast versus blood culture in clinical routine – A report on 3 years experience

Commercial Multiplex Technologies for the Microbiological Diagnosis of Sepsis

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