Molecular diagnosis of bloodstream infections with a new dual-priming oligonucleotide-based multiplex PCR assay.
Mortality from bloodstream infections (BSIs) correlates with diagnostic delay and the use of inappropriate empirical treatment. Early PCR-based diagnosis could decrease inappropriate treatment, improving patient outcome. The aim of the present study was to assess the clinical utility of this molecular technology to diagnose BSIs. We assessed a new dual-priming oligonucleotide-based multiplex PCR assay, the Magicplex Sepsis Test (MST) (Seegene), along with blood culture (BC). A total of 267 patients from the intensive care unit and haematology and emergency departments were enrolled. Clinical data were also used by physicians to determine the likelihood of infection. Ninety-eight (37 %) specimens were positive: 29 (11 %) by both the MST and BC, 29 (11 %) by the MST only, and 40 (15 %) by BC only. The proportion of agreement between the two methods was 73 % (Cohen's κ: 0.45; 0.28-0.6; indicating fair to moderate agreement). According to clinical assessment, 63 (64 %) positive specimens were considered BSIs: 23 (36 %) were positive by both the MST and BC, 22 (35 %) were positive only by BC, and 18 (29 %) were positive only by the MST. Thirty-eight (14 %) positive specimens by the MST and/or BC were considered as contaminants. Of 101 specimens collected from patients receiving antibiotics, 20 (20 %) were positive by the MST and 32 (32 %) by BC. Sensitivity and specificity were 65 % and 92 %, respectively, for the MST and 71 % and 88 %, respectively for BC. We concluded that the MST shows a high specificity but changes in design are needed to increase bacteraemia detection. For viability in clinical laboratories, technical improvements are also required to further automate the process.
Biomedical Research Institute Sant Pau (IIB Sant Pau), Sant Antoni Ma Claret 167, 08025 Barcelona, Spain.|Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
Lucrecia
L
Carrara
Biomedical Research Institute Sant Pau (IIB Sant Pau), Sant Antoni Ma Claret 167, 08025 Barcelona, Spain.|Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
Ferran
F
Navarro
Servicio de Urgencias Generales, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.|Biomedical Research Institute Sant Pau (IIB Sant Pau), Sant Antoni Ma Claret 167, 08025 Barcelona, Spain.
Miquel
M
Turbau
Servicio de Urgencias Generales, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.|Biomedical Research Institute Sant Pau (IIB Sant Pau), Sant Antoni Ma Claret 167, 08025 Barcelona, Spain.
Montse
M
Seres
Servicio de Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.|Biomedical Research Institute Sant Pau (IIB Sant Pau), Sant Antoni Ma Claret 167, 08025 Barcelona, Spain.
Indalecio
I
Morán
Servicio de Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.|Biomedical Research Institute Sant Pau (IIB Sant Pau), Sant Antoni Ma Claret 167, 08025 Barcelona, Spain.
Isabel
I
Quintana
Servicio de Hematología, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.|Biomedical Research Institute Sant Pau (IIB Sant Pau), Sant Antoni Ma Claret 167, 08025 Barcelona, Spain.
Rodrigo
R
Martino
Biomedical Research Institute Sant Pau (IIB Sant Pau), Sant Antoni Ma Claret 167, 08025 Barcelona, Spain.|Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
Yesica
Y
González
Biomedical Research Institute Sant Pau (IIB Sant Pau), Sant Antoni Ma Claret 167, 08025 Barcelona, Spain.|Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
Albert
A
Brell
Biomedical Research Institute Sant Pau (IIB Sant Pau), Sant Antoni Ma Claret 167, 08025 Barcelona, Spain.|Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
Oscar
O
Cordon
Biomedical Research Institute Sant Pau (IIB Sant Pau), Sant Antoni Ma Claret 167, 08025 Barcelona, Spain.|Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
Karol
K
Diestra
Biomedical Research Institute Sant Pau (IIB Sant Pau), Sant Antoni Ma Claret 167, 08025 Barcelona, Spain.|Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
Caterina
C
Mata
Biomedical Research Institute Sant Pau (IIB Sant Pau), Sant Antoni Ma Claret 167, 08025 Barcelona, Spain.|Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
Beatriz
B
Mirelis
Biomedical Research Institute Sant Pau (IIB Sant Pau), Sant Antoni Ma Claret 167, 08025 Barcelona, Spain.|Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
Pere
P
Coll
D016470:Bacteremia / Q000175:diagnosis*; D006801:Humans; D060885:Multiplex Polymerase Chain Reaction / Q000379:methods*; D009841:Oligonucleotides / Q000235:genetics; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D009841:Oligonucleotides