title: Microbial diagnosis of bloodstream infection: towards molecular diagnosis directly from blood.
abstract: When a bloodstream infection (BSI) is suspected, most of the laboratory results-biochemical and haematologic-are available within the first hours after hospital admission of the patient. This is not the case for diagnostic microbiology, which generally takes a longer time because blood culture, which is to date the reference standard for the documentation of the BSI microbial agents, relies on bacterial or fungal growth. The microbial diagnosis of BSI directly from blood has been proposed to speed the determination of the etiological agent but was limited by the very low number of circulating microbes during these paucibacterial infections. Thanks to recent advances in molecular biology, including the improvement of nucleic acid extraction and amplification, several PCR-based methods for the diagnosis of BSI directly from whole blood have emerged. In the present review, we discuss the advantages and limitations of these new molecular approaches, which at best complement the culture-based diagnosis of BSI.
authors: Institute of Microbiology, University of Lausanne and University Hospital Center, Lausanne, Switzerland.
authors: O
authors: O
authors: Opota
authors: Institute of Microbiology, University of Lausanne and University Hospital Center, Lausanne, Switzerland.
authors: K
authors: K
authors: Jaton
authors: Institute of Microbiology, University of Lausanne and University Hospital Center, Lausanne, Switzerland; Infectious Diseases Service, University of Lausanne and University Hospital Center, Lausanne, Switzerland. Electronic address: Gilbert.Greub@chuv.ch.
authors: G
authors: G
authors: Greub
mesh_terms: D001419:Bacteria / Q000235:genetics / Q000302:isolation & purification*; D001769:Blood / Q000382:microbiology*; D005658:Fungi / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D018805:Sepsis / Q000175:diagnosis*
keywords: Bacteremia; PCR/ESI-MS; blood culture; bloodstream infection; diagnosis; molecular