Towards an improved diagnosis of bloodstream infection: promises and hurdles

Lamy, Brigitte; Sundqvist, Martin

doi:10.1016/j.cmi.2018.02.025

Cited by 3 publications

(4 citation statements)

References 20 publications

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“…Using BCs as a comparator may not be appropriate due to limitations including sensitivity. We know that a number of factors can influence the diagnostic accuracy of BCs, and antimicrobial therapy prior to blood sampling is one such factor (among others) (Lamy et al, 2018). However, PCR-based detection of bacteria and fungi in culture-negative clinical samples, especially obtained from patients on antimicrobial therapy, continues to create a clinical interpretation challenge (Farrell et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Development of a Multiplex PCR Platform for the Rapid Detection of Bacteria, Antibiotic Resistance, and Candida in Human Blood Samples

Liotti

Posteraro

Mannu³

et al. 2019

Front. Cell. Infect. Microbiol.

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The diagnosis of bloodstream infections (BSIs) still relies on blood culture (BC), but low turnaround times may hinder the early initiation of an appropriate antimicrobial therapy, thus increasing the risk of infection-related death. We describe a direct and rapid multiplex PCR-based assay capable of detecting and identifying 16 bacterial and four Candida species, as well as three antibiotic-resistance determinants, in uncultured samples. Using whole-blood samples spiked with microorganisms at low densities, we found that the MicrobScan assay had a mean limit of detection of 15.1 ± 3.3 CFU of bacteria/Candida per ml of blood. When applied to positive BC samples, the assay allowed the sensitive and specific detection of BSI pathogens, including blaKPC-, mecA-, or vanA/vanB-positive bacteria. We evaluated the assay using prospectively collected blood samples from patients with suspected BSI. The sensitivity and specificity were 86.4 and 97.0%, respectively, among patients with positive BCs for the microorganisms targeted by the assay or patients fulfilling the criteria for infection. The mean times to positive or negative assay results were 5.3 ± 0.2 and 5.1 ± 0.1 h, respectively. Fifteen of 20 patients with MicrobScan assay-positive/BC-negative samples were receiving antimicrobial therapy. In conclusion, the MicrobScan assay is well suited to complement current diagnostic methods for BSIs.

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Section: Discussionmentioning

confidence: 99%

Development of a Multiplex PCR Platform for the Rapid Detection of Bacteria, Antibiotic Resistance, and Candida in Human Blood Samples

Liotti

Posteraro

Mannu³

et al. 2019

Front. Cell. Infect. Microbiol.

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“…Contamination: proportion of false positive blood CDST. Represents organisms introduced during blood sample collection or laboratory processing of the collected sample [18,44,45].…”

Section: Definition Of Termsmentioning

confidence: 99%

“…Laboratory identification of the pathogen and its antimicrobial susceptibility are essential to guide appropriate targeted antimicrobial therapy for severe bacterial infections, including BSI [2,[15][16][17]. Despite the general shift toward the utilisation of rapid diagnostic tests, including molecular tests, 'traditional' phenotypic tests like Gram stain with microscopy and Culture and Drug Susceptibility Testing (CDST) remain integral for the diagnosis and management of BSI [18][19][20][21]. Blood CDST, when performed in a timely manner and coupled with rapid communication of results, effectively improves clinical outcomes of patients with BSI [19,22].…”

Section: Introductionmentioning

confidence: 99%

“…These factors, all components of a laboratory quality system, influence the accuracy, reliability and timeliness of blood CDST results and, consequently, physician trust and, therefore, use of the test [23]. Periodic assessments of access to and quality of blood CDST services are therefore important for identifying and addressing systemic issues affecting blood CDST utilisation, improving laboratory efficiency and enhancing clinical practice [18,24,25].…”

Section: Introductionmentioning

confidence: 99%

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Use and Quality of Blood Cultures for the Diagnosis of Bloodstream Infections: A Cross-Sectional Study in the Ho Teaching Hospital, Ghana, 2019–2021

Boakye-Yiadom,

Najjemba,

Thekkur

et al. 2023

IJERPH

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Blood Culture and Drug Susceptibility Testing (CDST) remains vital for the diagnosis and management of bloodstream infections (BSIs). While the Ghana National Standard Treatment Guidelines require CDST to be performed in each case of suspected or clinically diagnosed BSI, these are poorly adhered to in the Ho Teaching Hospital (HTH). This study used secondary medical and laboratory records to describe blood CDST requests by clinicians and the quality of CDST processes for the diagnosis of BSI among patients admitted to HTH from 2019 to 2021. Of 4278 patients, 33% were infants. Pneumonia and neonatal sepsis cases were 40% and 22%, respectively. Only 8% (351/4278) had blood CDST requested. Of 94% (329/351) blood CDST processed and reported, only 7% (22/329) were culture-positive, with likely contaminants being recovered from 16% (52/329) of the specimens. The duration from admission to request was 2 days (IQR: 0–5), and Further qualitative studies must be conducted to understand the reasons for low blood CDST utilisation among clinicians and the patient outcomes. Targeted interventions are required to enhance the utilisation of blood CDST by clinicians and the quality of laboratory processes.

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Blood culture quality assurance: what Australasian laboratories are measuring and opportunities for improvement

Elvy¹,

Walker²,

Haremza³

et al. 2021

Pathology

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Towards an improved diagnosis of bloodstream infection: promises and hurdles

Cited by 3 publications

References 20 publications

Development of a Multiplex PCR Platform for the Rapid Detection of Bacteria, Antibiotic Resistance, and Candida in Human Blood Samples

Development of a Multiplex PCR Platform for the Rapid Detection of Bacteria, Antibiotic Resistance, and Candida in Human Blood Samples

Use and Quality of Blood Cultures for the Diagnosis of Bloodstream Infections: A Cross-Sectional Study in the Ho Teaching Hospital, Ghana, 2019–2021

Blood culture quality assurance: what Australasian laboratories are measuring and opportunities for improvement

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