title: Molecular diagnosis of bloodstream infections in onco-haematology patients with PCR/ESI-MS technology.
abstract: Onco-haematological patients are prone to develop infections, and antibiotic prophylaxis may lead to negative blood cultures. Thus, the microbiological diagnosis and subsequent administration of a targeted antimicrobial therapy is often difficult. The goal of this study was to evaluate the usefulness of IRIDICA (PCR/ESI-MS technology) for the molecular diagnosis of bloodstream infections in this patient group.
  
  
  
  A total of 463 whole blood specimens from different sepsis episodes in 429 patients were analysed using the PCR/ESI-MS platform, comparing the results with those of blood culture and other clinically relevant information.
  
  
  
  The sensitivity of PCR/ESI-MS by specimen (excluding polymicrobial infections, n = 25) in comparison with blood culture was 64.3% overall, 69.0% in oncological patients, and 59.3% in haematological patients. When comparing with a clinical infection criterion, overall sensitivity rose to 74.7%, being higher in oncological patients (80.0%) than in haematological patients (67.7%). Thirty-one microorganisms isolated by culture were not detected by IRIDICA, whereas 42 clinically relevant pathogens not isolated by culture were detected moleculary.
  
  
  
  PCR/ESI-MS offers a reliable identification of pathogens directly from whole blood. While additional studies are needed to confirm our findings, the system showed a lower sensitivity in onco-haematological patients in comparison with previously reported results in patients from the Intensive Care Unit.
authors.affiliation: Microbiology Service, Germans Trias i Pujol University Hospital, Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain; CIBER in Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Jordana-Lluch
authors.affiliation: Microbiology Service, Germans Trias i Pujol University Hospital, Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Rivaya
authors.affiliation: Microbiology Service, Germans Trias i Pujol University Hospital, Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain.
authors.forename: Clara
authors.initials: C
authors.lastname: Marcó
authors.affiliation: Microbiology Service, Germans Trias i Pujol University Hospital, Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain; CIBER in Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Giménez
authors.affiliation: Microbiology Service, Germans Trias i Pujol University Hospital, Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain.
authors.forename: Mª Dolores
authors.initials: MD
authors.lastname: Quesada
authors.affiliation: Oncology Department, Germans Trias i Pujol University Hospital, Badalona, Spain.
authors.forename: Agustín
authors.initials: A
authors.lastname: Escobedo
authors.affiliation: Haematology Department, Germans Trias i Pujol University Hospital, Badalona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Batlle
authors.affiliation: Microbiology Service, Germans Trias i Pujol University Hospital, Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain; CIBER in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. Electronic address: emartro@igtp.cat.
authors.forename: Elisa
authors.initials: E
authors.lastname: Martró
authors.affiliation: Microbiology Service, Germans Trias i Pujol University Hospital, Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain; CIBER in Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Ausina
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000150:complications / Q000175:diagnosis / Q000382:microbiology; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000295:instrumentation / Q000379:methods; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D021241:Spectrometry, Mass, Electrospray Ionization / Q000295:instrumentation / Q000379:methods; D055815:Young Adult
keywords: Bloodstream infection; Haematology; Molecular diagnosis; Oncology; PCR/ESI-MS