Sepsis Pathogen Identification

Chun, Katy; Syndergaard, Chas; Damas, Carlos; Trubey, Richard K.; Mukindaraj, Amruthavani; Qian, Shenyu; Jin, Xin; Breslow, Scott; Niemz, Angelika

doi:10.1177/2211068214567345

Cited by 61 publications

(48 citation statements)

References 114 publications

(157 reference statements)

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“…Newly introduced technologies such as PCR-based methods, fluorescence in situ hybridization and MALDI-TOF have expedited the causative pathogen identification (1,5,8,19). Also on the antimicrobial susceptibility testing (AST) scenario there are several chances to reduce the TAT: i) direct inoculation of automatic susceptibility testing instruments or use of young culture on agar media (12,13,17,20), and ii) use of liquid culture or time lapse microscopy based technologies (1,11,14).…”

Section: N O N -C O M M E R C I a L U S E O N L Ymentioning

confidence: 99%

Real life turnaround time of blood cultures in the clinical microbiology laboratory: results of the first Italian survey, May 2015

et al. 2016

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SummaryBackground and aims: Blood culture (BC) results are essential to guide antimicrobial chemotherapy for patients with sepsis. However, BC is a time-consuming exam, which can take several days. Reducing BCs turn around time (TAT) could impact on multiple outcome parameters and TAT monitoring is an important tool for measurement of microbiology laboratory performance. The aim of this study was to provide an overview of BC TATs among Italian microbiology laboratories.Materials and methods: Five laboratories collected and recorded, for a month period, date and time of the BC processing events. Cumulative TATs were analysed using the GraphPad software.Results: Participating laboratories reported data from 302 sepsis episodes. The median time from when the BC system produced a positive signal until Gram-stain results were reported was 7.6 hours. A rapid molecular identification and antimicrobial susceptibility testing (AST) was performed in 26.5% of BCs. Mean TAT for identification report was significantly lower when a molecular approach was adopted (12 vs. 28.7 hours, P<0.001). Similarly, results of the molecular AST were obtained more than 24 hours in advance compared with phenotypic AST (mean 13.2 vs. 47.6, P<0.001). TATs from BC positivity of laboratories opened 7 days/week were not significantly lower than those of laboratories opened 6 days/week.Conclusions: BC is a time-consuming exam, however, molecular identification and AST methods can drastically reduce time to results. The lack of difference between TATs observed for laboratories working 7 days/week and 6 days/week, coupled with a high rate of BCs turning positive during the night enable to conclude that the most urgent measure to reduce TATs is the expansion of laboratory regular duty hours. IntroductionSepsis is a severe disease associated with high morbidity and mortality (7). Although conflicting data exist, early administration of appropriate empirical antimicrobial therapy, coupled with supportive treatment, have been shown to have an important impact on outcome (6,9,10,16

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Section: N O N -C O M M E R C I a L U S E O N L Ymentioning

confidence: 99%

Real life turnaround time of blood cultures in the clinical microbiology laboratory: results of the first Italian survey, May 2015

et al. 2016

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“…Infectious sepsis in North America involves more than 500,000 humans annually, with a death rate of ∼40% depending on the severity of sepsis . These infections chiefly are triggered by bacteria, but viruses, fungi, and protozoa may also cause sepsis . In spite of extensive research in septic animals and humans, there has yet to be a Federal Drug Administration (FDA)‐approved drug specifically for treatment of sepsis.…”

Section: Introductionmentioning

confidence: 99%

New strategies for treatment of infectious sepsis

Ward

Fattahi

2019

Journal of Leukocyte Biology

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In this mini review, we describe the molecular mechanisms in polymicrobial sepsis that lead to a series of adverse events including activation of inflammatory and prothrombotic pathways, a faulty innate immune system, and multiorgan dysfunction. Complement activation is a wellestablished feature of sepsis, especially involving generation of C5a and C5b-9, along with engagement of relevant receptors for C5a. Activation of neutrophils by C5a leads to extrusion of DNA, forming neutrophil extracellular traps that contain myeloperoxidase and oxidases, along with extracellular histones. Generation of the distal complement activation product, C5b-9 (known as the membrane attack complex, MAC), also occurs in sepsis. C5b-9 activates the NLRP3 inflammasome, which damages mitochondria, together with appearance in plasma of IL-1 and IL-18.Histones are strongly proinflammatory as well as being prothrombotic, leading to activation of platelets and development of venous thrombosis. Multiorgan dysfunction is also a feature of sepsis. It is well known that septic cardiomyopathy, which if severe, can lead to death. This complication in sepsis is linked to reduced levels in cardiomyocytes of three critical proteins (SERCA2, NCX, Na + /K + -ATPase). The reductions in these three key proteins are complement-and histonedependent. Dysfunction of these ATPases is linked to the cardiomyopathy of sepsis. These data suggest novel targets in the setting of sepsis in humans. K E Y W O R D Scomplement receptors, complement, histones, NLRP3 inflammasome

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“…This can be very useful for many diagnostic sectors, especially when fast response, good sensitivity, and multiplexing of analysis are crucial aspects for the applicative use. In particular potential applications of this system should be in healthcare area for the detection of bacterial species for sepsis disease (Chun et al, ) and in food control sector for the detection of pathogens such as Legionella pneumophila and Salmonella where sensitivities of 10,000 and 100,000 CFU/ml are requested, respectively (Poltronieri, Mezzolla, Primiceri & Maruccio, ).…”

Section: Introductionmentioning

confidence: 99%

EWOD silicon biosensor for multiple nucleic acids analysis

Petralia

Motta²,

Conoci

2019

Biotech & Bioengineering

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In this paper, a miniaturized biosensor containing 96 silicon microchambers electroloaded with nano-volumes of liquid (EW-chip) is presented. The liquid electroloading is achieved by the appropriate modulation of interface properties. The surface chemistries have been studied to guarantee effective interface properties for both electrowetting on dielectric actuation and biocompatibility versus biochemical reactions. The silicon microchambers are 200 nl in volume and are connected to a specific system of electrodes able to deliver liquid sample on each well. The device also integrates temperature sensors and heaters to perform biochemical reactions. On that, the effectiveness of this device has been successfully proven towards the nucleic acids detection via real-time polymerase chain reaction amplification. Hepatitis B virus genome target has been used to assess the device performance. Results show very uniform amplification over the 96 microchambers without any cross-contamination process. These features make this system a very appealing potential solution for genetic point-of-care devices where a high level of parallelism of analysis is required. K E Y W O R D S bionsensor, EWOD, microchip, nucleic acids, silicon

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Sepsis Pathogen Identification

Cited by 61 publications

References 114 publications

Real life turnaround time of blood cultures in the clinical microbiology laboratory: results of the first Italian survey, May 2015

Real life turnaround time of blood cultures in the clinical microbiology laboratory: results of the first Italian survey, May 2015

New strategies for treatment of infectious sepsis

EWOD silicon biosensor for multiple nucleic acids analysis

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