title: Microbiological Diagnosis of Sepsis: Polymerase Chain Reaction System Versus Blood Cultures.
abstract: OBJECTIVE
  To compare the utility of a multiplex polymerase chain reaction system (SeptiFast) and blood cultures for detecting bacteria and fungi in blood samples from patients with severe sepsis or septic shock.
  
  
  METHODS
  In a prospective observational study, whole blood samples for SeptiFast testing and for culture were collected on admission from all patients with severe sepsis or septic shock admitted to the intensive care unit between July 2011 and September 2012. SeptiFast results were compared with blood and other culture results.
  
  
  RESULTS
  The probability of at least 1 microorganism being isolated at 6 hours was 13-fold higher with the SeptiFast test than with blood cultures (relative risk, 13.5; 95% CI, 5.05-36.06). Unlike culture results, SeptiFast test results were not associated with previous antibiotic consumption. The median time to the first positive blood culture result was 17 hours; SeptiFast results were available in 6 hours. SeptiFast detected genetic material from potentially multiresistant microorganisms in patients whose blood cultures showed no growth at all.
  
  
  CONCLUSIONS
  The SeptiFast test provided quicker microbiological diagnosis and identified significantly more microorganisms than blood cultures did, particularly when samples were collected after antibiotic therapy had started or infections were due to resistant bacteria and yeast.
authors.affiliation: Borja Suberviola and Alvaro Castellanos-Ortega are intensivists and Alicia Márquez-López and Carlos Fernández-Mazarrasa are microbiologists at University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain. Miguel Santibañez is an assistant professor, Fundación Marqués de Valdecilla-IDIVAL, University of Cantabria, School of Nursing, Santander, Spain. Luis Martínez Martínez is a microbiologist at University Hospital Marqués de Valdecilla-IDIVAL and an assistant professor, Department of Molecular Biology, School of Medicine, University of Cantabria, Santander, Spain. bsuberviola@yahoo.es.
authors.forename: Borja
authors.initials: B
authors.lastname: Suberviola
authors.affiliation: Borja Suberviola and Alvaro Castellanos-Ortega are intensivists and Alicia Márquez-López and Carlos Fernández-Mazarrasa are microbiologists at University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain. Miguel Santibañez is an assistant professor, Fundación Marqués de Valdecilla-IDIVAL, University of Cantabria, School of Nursing, Santander, Spain. Luis Martínez Martínez is a microbiologist at University Hospital Marqués de Valdecilla-IDIVAL and an assistant professor, Department of Molecular Biology, School of Medicine, University of Cantabria, Santander, Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: Márquez-López
authors.affiliation: Borja Suberviola and Alvaro Castellanos-Ortega are intensivists and Alicia Márquez-López and Carlos Fernández-Mazarrasa are microbiologists at University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain. Miguel Santibañez is an assistant professor, Fundación Marqués de Valdecilla-IDIVAL, University of Cantabria, School of Nursing, Santander, Spain. Luis Martínez Martínez is a microbiologist at University Hospital Marqués de Valdecilla-IDIVAL and an assistant professor, Department of Molecular Biology, School of Medicine, University of Cantabria, Santander, Spain.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Castellanos-Ortega
authors.affiliation: Borja Suberviola and Alvaro Castellanos-Ortega are intensivists and Alicia Márquez-López and Carlos Fernández-Mazarrasa are microbiologists at University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain. Miguel Santibañez is an assistant professor, Fundación Marqués de Valdecilla-IDIVAL, University of Cantabria, School of Nursing, Santander, Spain. Luis Martínez Martínez is a microbiologist at University Hospital Marqués de Valdecilla-IDIVAL and an assistant professor, Department of Molecular Biology, School of Medicine, University of Cantabria, Santander, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernández-Mazarrasa
authors.affiliation: Borja Suberviola and Alvaro Castellanos-Ortega are intensivists and Alicia Márquez-López and Carlos Fernández-Mazarrasa are microbiologists at University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain. Miguel Santibañez is an assistant professor, Fundación Marqués de Valdecilla-IDIVAL, University of Cantabria, School of Nursing, Santander, Spain. Luis Martínez Martínez is a microbiologist at University Hospital Marqués de Valdecilla-IDIVAL and an assistant professor, Department of Molecular Biology, School of Medicine, University of Cantabria, Santander, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Santibáñez
authors.affiliation: Borja Suberviola and Alvaro Castellanos-Ortega are intensivists and Alicia Márquez-López and Carlos Fernández-Mazarrasa are microbiologists at University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain. Miguel Santibañez is an assistant professor, Fundación Marqués de Valdecilla-IDIVAL, University of Cantabria, School of Nursing, Santander, Spain. Luis Martínez Martínez is a microbiologist at University Hospital Marqués de Valdecilla-IDIVAL and an assistant professor, Department of Molecular Biology, School of Medicine, University of Cantabria, Santander, Spain.
authors.forename: Luis Martínez
authors.initials: LM
authors.lastname: Martínez
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000097:blood / Q000175:diagnosis / Q000382:microbiology; D001419:Bacteria / Q000235:genetics / Q000302:isolation & purification*; D060085:Coinfection / Q000097:blood / Q000175:diagnosis / Q000382:microbiology; D004269:DNA, Bacterial / Q000097:blood*; D004271:DNA, Fungal / Q000097:blood*; D042241:Early Diagnosis; D005188:False Negative Reactions; D005260:Female; D016469:Fungemia / Q000097:blood / Q000175:diagnosis / Q000382:microbiology; D005658:Fungi / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008828:Microbiological Techniques; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology; D012772:Shock, Septic / Q000097:blood / Q000175:diagnosis / Q000382:microbiology; D013997:Time Factors
chemical_list: D004269:DNA, Bacterial; D004271:DNA, Fungal