Early bacterial genome detection in body fluids from patients with severe sepsis: a pilot study.
OBJECTIVE
The purpose of this study is to evaluate the feasibility and interest of real-time polymerase chain reaction (RT-PCR) testing for bacterial genomes in body fluids other than blood in patients with acute severe sepsis.


METHODS
Twenty-six consecutive patients admitted for severe sepsis or septic shock were prospectively studied. Body fluids were sampled as clinically indicated and tested using standard microbiological methods and modified RT-PCR methods (universal PCR and specific PCRs). Results of standard microbiological tests were compared with those of PCR tests.


RESULTS
Direct RT-PCR testing was successfully performed on all nonblood body fluids. Of 29 body fluids collected, 23 were positive for at least 1 microorganism with conventional tests. Of 18 microbiological tests positive for a single microorganism, 15 fully agreed with RT-PCR assays, and the remaining 3 samples were infected with bacteria not screened by PCR testing. Among the 5 polymicrobial results obtained with conventional tests, RT-PCR agreed in 4 patients. The RT-PCR tests allowed additional clinically relevant bacterial identification in 3 of 6 samples with negative microbiological culture.


CONCLUSIONS
Our results indicate that direct PCR testing may improve the detection of bacteria in body fluids other than blood in patients with acute severe sepsis.
Medical-Surgical Intensive Care Unit, CHU Dupuytren, Limoges, France.
Anthony
A
Dugard
Delphine
D
Chainier
Olivier
O
Barraud
Fabien
F
Garnier
Marie-Cécile
MC
Ploy
Philippe
P
Vignon
Bruno
B
François
D000368:Aged; D001419:Bacteria / Q000235:genetics; D015373:Bacterial Typing Techniques / Q000379:methods*; D001431:Bacteriological Techniques; D001826:Body Fluids / Q000382:microbiology*; D005260:Female; D016680:Genome, Bacterial; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D060888:Real-Time Polymerase Chain Reaction; D018805:Sepsis / Q000175:diagnosis* / Q000382:microbiology*