title: SeptiFast versus blood culture in clinical routine - A report on 3 years experience.
abstract: BACKGROUND
  In recent years a multiplex real-time PCR (SeptiFast) has been introduced, allowing detection of 25 common blood pathogens considerably faster than conventional blood culture.
  
  
  METHODS
  SeptiFast was applied routinely in addition to blood culture in cases of critically ill patients with fever and other signs of severe systemic infections. In this study data of 470 episodes were retrospectively analysed to assess the impact of various parameters, such as clinical indications, assigning ward and antimicrobial treatment on test outcome using a multivariate logistic model.
  
  
  RESULTS
  After exclusion of microorganisms classified as contaminants, the concordance between SeptiFast and blood culture was 85.5%. SeptiFast detected 98 out of 120, while blood culture merely found 63 out of 120 potential pathogens. In comparison to blood culture, SeptiFast showed considerably higher positivity rates in sepsis, pneumonia and febrile immunosuppression and a lower rate in endocarditis. The highest positivity and concordance between tests was shown in patients from the emergency room (P = 0.007).
  
  
  CONCLUSIONS
  The results obtained in this study are similar to those from prospective settings confirming the robustness of the SeptiFast assay in routine use. Our data suggest that SeptiFast is a valuable add-on to blood culture and may increase the diagnostic efficiency of a microbiological laboratory.
authors.affiliation: Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.|Praxis Dr. med. Norbert Haßfurther, Launsbach, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Korber
authors.affiliation: Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Iris
authors.initials: I
authors.lastname: Zeller
authors.affiliation: Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Michaela
authors.initials: M
authors.lastname: Grünstäudl
authors.affiliation: Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Birgit
authors.initials: B
authors.lastname: Willinger
authors.affiliation: Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.|Krankenhaus der Elisabethinen Linz, Linz, Austria.
authors.forename: Petra
authors.initials: P
authors.lastname: Apfalter
authors.affiliation: Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Hirschl
authors.affiliation: Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. athanasios.makristathis@meduniwien.ac.at.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Makristathis
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000097:blood* / Q000175:diagnosis* / Q000382:microbiology; D000071997:Blood Culture / Q000379:methods*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis* / Q000382:microbiology; D055815:Young Adult
keywords: Blood culture; Diagnostics; Routine use; Sepsis; SeptiFast