title: Prospective comparison of a PCR assay and a microbiological culture technique for identification of pathogens from blood and non-blood samples in septic patients.
abstract: BACKGROUND
  Molecular amplification techniques are suggested to be a useful adjunct in early detection of pathogens in septic patients. The aim was to study the feasibility of a polymerase chain reaction (PCR) assay compared to the standard microbiological culture (MC) technique in identification of pathogenic microorganisms from blood and non-blood samples in septic patients.
  
  
  METHODS
  Samples for pathogen identification were taken during febrile septic episodes (SE) in 54 patients with sepsis and analyzed using both MC and PCR. Semi-automated multiplex PCR, provided by Philips Medical Systems, was able to detect nine different pathogens. The accuracy of pathogen identification using PCR vs. MC as well as the time-saving effect of PCR on the potential decision-making process for antimicrobial therapy was evaluated.
  
  
  RESULTS
  In a total of 258 samples taken during 87 SE, both methods yielded more pathogens from the non-blood than blood samples (87 % vs. 45 %; p = 0.002). PCR identified more pathogens than MC in the blood samples (98 vs. 21; p < 0.0001), but not in other body fluids. In 35 SE, the potential decision on appropriate antimicrobial therapy based on PCR results could have been made 50 (median; interquartile range 35-87) hours earlier than decisions based on standard MC.
  
  
  CONCLUSIONS
  In septic patients, multiplex PCR identified more pathogenic microorganisms isolated from the blood samples than the standard MC technique. In the non-blood samples, PCR was comparable to that of MC.
authors.affiliation: Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: Runa
authors.initials: R
authors.lastname: Plettig
authors.affiliation: Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Nowak
authors.affiliation: Friedrich Loeffler Institute of Medical Microbiology, University Medicine of Greifswald, Greifswald, Germany.
authors.forename: Veronika
authors.initials: V
authors.lastname: Balau
authors.affiliation: Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Medicine, University Medicine of Greifswald, Greifswald, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Hahnenkamp
authors.affiliation: Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Medicine, University Medicine of Greifswald, Greifswald, Germany.
authors.forename: Taras
authors.initials: T
authors.lastname: Usichenko
keywords: Microbiological culture; Molecular-based diagnostics; Sepsis