title: Improving the diagnosis of bloodstream infections: PCR coupled with mass spectrometry.
abstract: The reference method for the diagnosis of bloodstream infections is blood culture followed by biochemical identification and antibiotic susceptibility testing of the isolated pathogen. This process requires 48 to 72 hours. The rapid administration of the most appropriate antimicrobial treatment is crucial for the survival of septic patients; therefore, a rapid method that enables diagnosis directly from analysis of a blood sample without culture is needed. A recently developed platform that couples broad-range PCR amplification of pathogen DNA with electrospray ionization mass spectrometry (PCR/ESI-MS) has the ability to identify virtually any microorganism from direct clinical specimens. To date, two clinical evaluations of the PCR/ESI-MS technology for the diagnosis of bloodstream infections from whole blood have been published. Here we discuss them and describe recent improvements that result in an enhanced sensitivity. Other commercially available assays for the molecular diagnosis of bloodstream infections from whole blood are also reviewed. The use of highly sensitive molecular diagnostic methods in combination with conventional procedures could substantially improve the management of septic patients.
authors.affiliation: Servei de Microbiologia, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Jordana-Lluch
authors.affiliation: Servei de Microbiologia, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Giménez
authors.affiliation: Servei de Microbiologia, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain.
authors.forename: M Dolores
authors.initials: MD
authors.lastname: Quesada
authors.affiliation: Servei de Microbiologia, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain ; CIBER Enfermedades Respiratorias (CIBERES), 07110 Bunyola, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Ausina
authors.affiliation: Servei de Microbiologia, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain ; CIBER Epidemiología y Salud Pública (CIBERESP), 08036 Barcelona, Spain.
authors.forename: Elisa
authors.initials: E
authors.lastname: Martró
mesh_terms: D000818:Animals; D001424:Bacterial Infections / Q000097:blood* / Q000175:diagnosis*; D006801:Humans; D013058:Mass Spectrometry / Q000379:methods*; D025202:Molecular Diagnostic Techniques; D016133:Polymerase Chain Reaction / Q000379:methods*; D011933:Reagent Kits, Diagnostic
chemical_list: D011933:Reagent Kits, Diagnostic