title: Comparison of nested, multiplex, qPCR; FISH; SeptiFast and blood culture methods in detection and identification of bacteria and fungi in blood of patients with sepsis.
abstract: BACKGROUND
  Microbiological diagnosis of sepsis relies primarily on blood culture data. This study compares four diagnostic methods, i.e. those developed by us: nested, multiplex, qPCR (qPCR) and FISH with commercial methods: SeptiFast (Roche) (SF) and BacT/ALERT® 3D blood culture system (bioMérieux). Blood samples were derived from adult patients with clinical symptoms of sepsis, according to SIRS criteria, hospitalized in the Intensive Care Unit.
  
  
  RESULTS
  Using qPCR, FISH, SF, and culture, microbial presence was found in 71.8%, 29.6%, 25.3%, and 36.6% of samples, respectively. It was demonstrated that qPCR was significantly more likely to detect microorganisms than the remaining methods; qPCR confirmed the results obtained with the SF kit in all cases wherein bacteria were detected with simultaneous confirmation of Gram-typing. All data collected through the FISH method were corroborated by qPCR.
  
  
  CONCLUSIONS
  The qPCR and FISH methods described in this study may constitute alternatives to blood culture and to the few existing commercial molecular assays since they enable the detection of the majority of microbial species, and the qPCR method allows their identification in a higher number of samples than the SF test. FISH made it possible to show the presence of microbes in a blood sample even before its culture.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Gosiewski
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Flis
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Sroka
authors.forename: Anna
authors.initials: A
authors.lastname: Kędzierska
authors.forename: Agata
authors.initials: A
authors.lastname: Pietrzyk
authors.forename: Jolanta
authors.initials: J
authors.lastname: Kędzierska
authors.forename: Rafał
authors.initials: R
authors.lastname: Drwiła
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Bulanda
mesh_terms: D001419:Bacteria / Q000235:genetics*; D046508:Culture Techniques / Q000379:methods; D005658:Fungi / Q000235:genetics*; D006801:Humans; D017404:In Situ Hybridization, Fluorescence / Q000379:methods; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D060885:Multiplex Polymerase Chain Reaction / Q000379:methods; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods; D018805:Sepsis / Q000382:microbiology*