Mikrobiologisches Sepsis-Screening chirurgischer Intensivpatienten mit dem „Lightcycler“ Septifast®-Test – eine Pilotstudie

Abstract

This first systematic use of the time-saving LightCycler Septifast test shows that it can detect bacteremia in surgical patients at the ICU, with, in part, negative blood cultures. Positive Septifast test results which cannot be explained by clinical symptoms, occur rarely. The detection of pathological microbes with the Septifast test provides additional findings (72.2 %) for therapeutic decision-making, which can be obtained considerably more rapidly in comparison with conventional microbiological cultures (a few hours versus 2 days). For surgical patients with SIRS and subsequent need of intensive care, a Septifast test should be considered. In conclusion, it is recommended that the test should be further and systematically investigated.

PCR-based rapid sepsis diagnosis effectively guides clinical treatment in patients with new onset of SIRS

“…In accordance to previous studies, our study confirmed the good concordance of PCR results with BC as well [16,21]. Although rapid and specific, an important limitation of the current PCR assay might arise from the fact that some pathogens are not part of the detection panel.…”

“…Since then, several groups have demonstrated the good concordance of PCR results with BC. Moreover, an increased sensitivity of PCR-based detection of blood stream infections was confirmed in different patient groups [15,16,19,20]. All these studies were indicative of potential clinical utility of PCR-based detection of bloodstream infections in patients with sepsis or suspected sepsis.…”

“…Generally, the positive yields of BC do not exceed 5-30% in septic patients, mainly depending on the severity of the disease and localisation of the infection. The present study as well as our first study [16] focussed on patients on the surgical ICU with predominant risk of abdominal sepsis. In the first study, a systematic microbiological screening was performed in all patients at the ICU and the positivity rate reached only 12%.…”

“…In this regard, a new commercially available kit (SeptiFast®) to detect DNA from 25 clinically relevant pathogens in blood has recently been evaluated in different patient groups with promising results [14,15]. Results are awaited within 6 h. Quite recently, we have shown that the commercially available multiplex-PCR system identifies 90% of sepsis-related microorganisms in blood samples without prior culture and detects the microbiological origin of infection in 40-50% of patients with SIRS parameters [16]. Therefore, we asked whether patients at the time point of upcoming SIRS parameters may benefit from multiplex-PCR-based detection of microorganisms.…”

Resistenzentwicklung in der operativen Intensivtherapie

“…B. CRP, PCT) und insbesondere der klinische Verlauf als wohl wichtigster Faktor herangezogen werden. Ein weiterer Punkt zur Begrenzung und dem Angehen von Antibiotikaresistenzen ist die Entwicklung und Zulassung neuer antimikrobieller Substanzen[20][21][22]. Diese können jedoch ebenso wenig das Problem allein lösen.…”