title: Commercial multiplex technologies for the microbiological diagnosis of sepsis.
abstract: In patients with suspected sepsis, rapid and accurate diagnosis of the causative infectious agent is critical. Although clinicians often use empiric antimicrobial therapy until the blood cultures are available to potentially adjust treatment, this approach is often not optimum for patient care. Recently, several commercial molecular multiplex technologies have shown promise for fast and comprehensive diagnosis of microorganisms and their antimicrobial resistance signatures. While one class of multiplex technologies is directed at improving the speed and diagnostic information obtained from positive blood cultures, the other identifies the causative microorganisms directly from clinical blood samples. This review provides an overview of these molecular technologies and describes their performance capabilities compared to standard blood cultures and in some cases to each other. We discuss the current clinical impact, limitations, and likely futures advances these multiplex technologies may have in guiding the management of patients with sepsis.
authors: Department of Perioperative Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
authors: Evan E
authors: EE
authors: Lebovitz
authors: Peter D
authors: PD
authors: Burbelo
mesh_terms: D001773:Blood Cells / Q000166:cytology / Q000382:microbiology; D006801:Humans; D025202:Molecular Diagnostic Techniques; D016133:Polymerase Chain Reaction; D018805:Sepsis / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology
references: Crit Care Med. 2009 Dec;37(12):3085-90
references: 19633541
references: J Clin Microbiol. 2011 Jun;49(6):2252-8
references: 21471340
references: Clin Chem. 2004 Aug;50(8):1301-14
references: 15166107
references: Crit Care Med. 2013 Feb;41(2):580-637
references: 23353941
references: J Clin Microbiol. 2011 Aug;49(8):2988-91
references: 21715593
references: Transpl Infect Dis. 2009 Apr;11(2):175-8
references: 19210691
references: N Engl J Med. 2001 Nov 8;345(19):1368-77
references: 11794169
references: NCHS Data Brief. 2011 Jun;(62):1-8
references: 22142805
references: Lancet Infect Dis. 2004 Dec;4(12):751-60
references: 15567125
references: Diagn Microbiol Infect Dis. 2012 Dec;74(4):349-55
references: 22999332
references: J Med Microbiol. 2008 May;57(Pt 5):601-604
references: 18436593
references: J Clin Microbiol. 2013 Apr;51(4):1130-6
references: 23363819
references: J Clin Microbiol. 2011 Aug;49(8):2919-23
references: 21715592
references: N Engl J Med. 2008 Jan 10;358(2):111-24
references: 18184957
references: Ther Clin Risk Manag. 2008 Jun;4(3):637-40
references: 18827860
references: Eur J Clin Microbiol Infect Dis. 2011 Sep;30(9):1127-34
references: 21373774
references: BMC Infect Dis. 2009 Aug 11;9:126
references: 19671147
references: J Infect. 2010 Oct;61(4):335-42
references: 20637801
references: Diagn Microbiol Infect Dis. 2013 Feb;75(2):130-4
references: 23177222
references: Klin Padiatr. 2012 Jan;224(1):12-6
references: 22258624
references: PLoS One. 2012;7(9):e46003
references: 23029360
references: J Med Microbiol. 2012 Jun;61(Pt 6):881-883
references: 22403141
references: J Crit Care. 2013 Feb;28(1):2-8
references: 22999484
references: Crit Care Med. 2003 Apr;31(4):1250-6
references: 12682500
references: J Clin Microbiol. 2012 Nov;50(11):3635-40
references: 22952267
references: Eur J Clin Microbiol Infect Dis. 2013 Jul;32(7):955-9
references: 23397233
references: Zentralbl Chir. 2009 Jun;134(3):249-53
references: 19536720
references: BMC Microbiol. 2009 Aug 10;9:161
references: 19664269
references: Int J Infect Dis. 2011 May;15(5):e326-31
references: 21353616
references: J Microbiol Methods. 2011 Jun;85(3):206-13
references: 21397640
references: Intensive Care Med. 2010 Feb;36(2):241-7
references: 19924398
references: Clin Microbiol Rev. 1997 Jul;10(3):444-65
references: 9227861
references: Crit Care. 2008;12(6):R158
references: 19091069
references: Shock. 2010 Jul;34(1):27-30
references: 20090568
references: J Clin Microbiol. 2011 Apr;49(4):1581-2
references: 21270213
references: Clin Microbiol Infect. 2009 Jun;15(6):544-51
references: 19392905
references: J R Soc Med. 1992 Mar;85(3):180
references: 1556728
references: Ann Emerg Med. 2005 Sep;46(3):228-31
references: 16126131
references: J Clin Microbiol. 2003 Jul;41(7):3119-25
references: 12843051
references: Clin Microbiol Infect. 2010 Jun;16(6):774-9
references: 19689465
references: Infect Control Hosp Epidemiol. 2005 Feb;26(2):166-74
references: 15756888
references: J Antimicrob Chemother. 2006 Jul;58(1):154-8
references: 16636084
references: JAMA. 1997 Jul 16;278(3):234-40
references: 9218672
references: J Clin Microbiol. 2012 Jul;50(7):2250-4
references: 22553237
references: Gynecol Obstet Invest. 2010;70(3):215-6
references: 20639648
references: J Clin Microbiol. 2012 Apr;50(4):1285-8
references: 22322348
references: Eur J Clin Microbiol Infect Dis. 2009 Jun;28(6):569-73
references: 19048317
references: Clin Microbiol Infect. 2006 Aug;12(8):745-53
references: 16842569
references: PLoS One. 2010 Oct 13;5(10):e13387
references: 20967222
references: J Infect. 2009 May;58(5):346-51
references: 19362374
references: N Engl J Med. 2003 Apr 17;348(16):1546-54
references: 12700374
references: J Microbiol Methods. 2013 Mar;92(3):253-5
references: 23266578
references: J Clin Microbiol. 2009 Apr;47(4):1274-5
references: 19171685
references: J Clin Microbiol. 2009 Sep;47(9):2759-65
references: 19571030
references: Clin Chem Lab Med. 2008;46(7):888-908
references: 18624614
references: J Chemother. 2007 Oct;19 Suppl 2:31-4
references: 18073177
references: Crit Care Med. 1999 May;27(5):937-40
references: 10362416
references: Lancet. 2005 Jan 1-7;365(9453):63-78
references: 15639681
references: Diagn Microbiol Infect Dis. 2011 Aug;70(4):534-7
references: 21767711
references: Nat Rev Microbiol. 2010 Jan;8(1):74-82
references: 20010952
references: J Clin Microbiol. 2013 Apr;51(4):1188-92
references: 23363838
references: N Engl J Med. 1999 Jan 21;340(3):207-14
references: 9895401
references: Crit Care. 2012 Jan 17;16(1):404
references: 22264298
references: PLoS One. 2011;6(11):e26655
references: 22132076
references: PLoS One. 2012;7(6):e38916
references: 22719987
references: J Infect Dis. 2002 Dec 1;186(11):1677-81
references: 12447747
references: Clin Microbiol Rev. 2010 Jan;23(1):235-51
references: 20065332
references: Lancet Infect Dis. 2004 Jun;4(6):337-48
references: 15172342
references: Lancet. 2010 Jan 16;375(9710):224-30
references: 20004964
references: J Med Microbiol. 2012 Nov;61(Pt 11):1556-1562
references: 22899780
references: Chest. 2009 Nov;136(5):1237-1248
references: 19696123
references: Mol Diagn Ther. 2013 Apr;17(2):117-22
references: 23345071
references: J Med Microbiol. 2008 Oct;57(Pt 10):1306-1307
references: 18809565