title: Routine use of a real-time polymerase chain reaction method for detection of bloodstream infections in neutropaenic patients.
abstract: We examined the performance of a real-time polymerase chain reaction (PCR) test (SeptiFast) for early detection of bloodstream infection in febrile neutropaenic patients. Blood samples from 201 patients were screened for pathogens by blood culture and by PCR on the first day of fever. PCR results were available earlier (median 3 days for bacteria, 5 days fungal pathogens; P ≤ 0.01). The sensitivity (0.74) and specificity (0.96) of the PCR test were acceptable for Gram negatives when culture was considered the gold standard, but sensitivity of the test was poorer for Gram-positive organisms (0.39). The PCR assay also led to 22.9% of invalid results. SeptiFast speeds the microbiological diagnosis of bloodstream infection in neutropaenic patients. However, the frequent failure of instrumental control procedures, the relatively poor sensitivity of the test, and the lack of phenotypic data on antimicrobial susceptibility associated with its high costs suggest that this assay cannot replace the blood cultures.
authors.affiliation: Unit of Microbiology, Department of Specialistic, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Paolucci
authors.forename: Marta
authors.initials: M
authors.lastname: Stanzani
authors.forename: Fraia
authors.initials: F
authors.lastname: Melchionda
authors.forename: Giulia
authors.initials: G
authors.lastname: Tolomelli
authors.forename: Gastone
authors.initials: G
authors.lastname: Castellani
authors.forename: Maria Paola
authors.initials: MP
authors.lastname: Landini
authors.forename: Stefania
authors.initials: S
authors.lastname: Varani
authors.forename: Russell E
authors.initials: RE
authors.lastname: Lewis
authors.forename: Vittorio
authors.initials: V
authors.lastname: Sambri
mesh_terms: D016470:Bacteremia / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology; D001419:Bacteria / Q000235:genetics / Q000302:isolation & purification; D005334:Fever / Q000382:microbiology*; D016469:Fungemia / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology; D005658:Fungi / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D009196:Myeloproliferative Disorders / Q000097:blood / Q000382:microbiology; D009503:Neutropenia / Q000382:microbiology*; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity