title: Detection of bacteria and fungi in blood of patients with febrile neutropenia by real-time PCR with universal primers and probes.
abstract: Febrile neutropenia is the main treatment-related cause of mortality in cancer patients. During June 2012 to April 2014, 97 blood culture samples were collected from patients receiving chemotherapy for hematological malignancy and cancer with febrile neutropenia episodes (FNEs). The samples were examined for the presence of bacteria and fungi using real-time PCR amplification and sequencing of 16S and 18S rRNA genes. Bacteria were identified in 20 of 97 samples (20.6%) by the real-time PCR assay and in 10 of 97 (10.3%) samples by blood culture. In 6 blood culture-positive samples, the real-time PCR assay detected the same type of bacteria. No fungi were detected by the real-time PCR assay or blood culture. During antibiotic therapy, all samples were negative by blood culture, but the real-time PCR assay yielded a positive result in 2 cases of 2 (100%). The bacterial DNA copy number was not well correlated with the serum C-reactive protein titer of patients with FNEs. We conclude that a real-time PCR assay could provide better detection of causative microbes' in a shorter time, and with a smaller blood sample than blood culture. Using a real-time PCR assay in combination with blood culture could improve microbiological documentation of FNEs.
authors.affiliation: Department of Pediatrics, Kawasaki Medical School, Kurashiki-shi, Okayama, Japan. Electronic address: teranishi.h@med.kawasaki-m.ac.jp.
authors.forename: Hideto
authors.initials: H
authors.lastname: Teranishi
authors.affiliation: Department of Pediatrics, Kawasaki Medical School, Kurashiki-shi, Okayama, Japan.
authors.forename: Nanae
authors.initials: N
authors.lastname: Ohzono
authors.affiliation: Department of Pediatrics, Kawasaki Medical School, Kurashiki-shi, Okayama, Japan.
authors.forename: Norikazu
authors.initials: N
authors.lastname: Inamura
authors.affiliation: Department of Pediatrics, Kawasaki Medical School, Kurashiki-shi, Okayama, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kato
authors.affiliation: Department of Pediatrics, Kawasaki Medical School, Kurashiki-shi, Okayama, Japan.
authors.forename: Tokio
authors.initials: T
authors.lastname: Wakabayashi
authors.affiliation: Department of Pediatrics, Kawasaki Medical School, Kurashiki-shi, Okayama, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Akaike
authors.affiliation: Department of Pediatrics, Kawasaki Medical School, Kurashiki-shi, Okayama, Japan.
authors.forename: Kihei
authors.initials: K
authors.lastname: Terada
authors.affiliation: Department of Pediatrics, Kawasaki Medical School, Kurashiki-shi, Okayama, Japan.
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Ouchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000097:blood*; D001769:Blood / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D017931:DNA Primers / Q000737:chemistry; D015342:DNA Probes / Q000737:chemistry; D064147:Febrile Neutropenia / Q000097:blood* / Q000382:microbiology; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000097:blood*; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D055815:Young Adult
chemical_list: D017931:DNA Primers; D015342:DNA Probes
keywords: Bacteria; Blood culture; Febrile neutropenia; Fungi; Real-time PCR assay