title: Rapid Diagnosis of Staphylococcal Catheter-Related Bacteraemia in Direct Blood Samples by Real-Time PCR.
abstract: Catheter-related bacteremia (CRB) is an important cause of morbidity and mortality among hospitalized patients, being staphylococci the main etiologic agents. The objective of this study was to assess the use of a PCR-based assay for detection of staphylococci directly from blood obtained through the catheter to diagnose CRB caused by these microorganisms and to perform a cost-effectiveness analysis. A total of 92 patients with suspected CRB were included in the study. Samples were obtained through the catheter. Paired blood cultures were processed by standard culture methods and 4 ml blood samples were processed by GeneXpert-MRSA assay for the detection of methicillin-susceptible (MSSA) or methicillin-resistant (MRSA) Staphylococcus aureus, and methicillin-resistant coagulase-negative staphylococci (MR-CoNS). Sixteen CRB caused by staphylococci were diagnosed among 92 suspected patients. GeneXpert detected 14 out of 16 cases (87.5%), including 4 MSSA and 10 MR-CoNS in approximately 1 hour after specimen receipt. The sensitivity and specificity of GeneXpert were 87.5% (CI 95%: 60.4-97.8) and 92.1% (CI 95%: 83-96.7), respectively, compared with standard culture methods. The sensitivity of GeneXpert for S. aureus was 100%. Regarding a cost-effectiveness analysis, the incremental cost of using GeneXpert was of 31.1€ per patient while the incremental cost-effectiveness ratio of GeneXpert compared with blood culture alones was about 180€ per life year gained. In conclusion, GeneXpert can be used directly with blood samples obtained through infected catheters to detect S. aureus and MR-CoNS in approximately 1h after sampling. In addition, it is cost-effective especially in areas with high prevalence of staphylococcal CRB.
authors: Department of Clinical Microbiology, Biomedical Diagnostic Centre (CDB), Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain.
authors: Yuliya
authors: Y
authors: Zboromyrska
authors: Department of Infectious Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors: Cristina
authors: C
authors: De la Calle
authors: Health Technology Assessment Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors: Marcelo
authors: M
authors: Soto
authors: Health Technology Assessment Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors: Laura
authors: L
authors: Sampietro-Colom
authors: Department of Infectious Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors: Alex
authors: A
authors: Soriano
authors: Department of Clinical Microbiology, Biomedical Diagnostic Centre (CDB), Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain.
authors: Míriam José
authors: MJ
authors: Alvarez-Martínez
authors: Department of Clinical Microbiology, Biomedical Diagnostic Centre (CDB), Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain.
authors: Manel
authors: M
authors: Almela
authors: Department of Clinical Microbiology, Biomedical Diagnostic Centre (CDB), Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain.|ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors: Francesc
authors: F
authors: Marco
authors: Department of Clinical Microbiology, Biomedical Diagnostic Centre (CDB), Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain.
authors: Ruth
authors: R
authors: Arjona
authors: Department of Infectious Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors: Nazaret
authors: N
authors: Cobos-Trigueros
authors: Department of Infectious Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors: Laura
authors: L
authors: Morata
authors: Department of Infectious Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors: José
authors: J
authors: Mensa
authors: Department of Infectious Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors: José Antonio
authors: JA
authors: Martínez
authors: CDB, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain.
authors: Aurea
authors: A
authors: Mira
authors: Department of Clinical Microbiology, Biomedical Diagnostic Centre (CDB), Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain.|ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors: Jordi
authors: http://orcid.org/0000-0002-8025-3926
authors: J
authors: Vila
mesh_terms: D016470:Bacteremia / Q000175:diagnosis* / Q000209:etiology* / Q000382:microbiology; D002408:Catheters, Indwelling / Q000382:microbiology*; D006801:Humans; D016106:Methicillin Resistance; D055624:Methicillin-Resistant Staphylococcus aureus / Q000472:pathogenicity; D008826:Microbial Sensitivity Tests; D060888:Real-Time Polymerase Chain Reaction; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000209:etiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000235:genetics / Q000472:pathogenicity*