Abstract:
:Infection is an important complication in patients with hematologic malignancies or solid tumors undergoing intensive cytotoxic chemotherapy. In only 20 to 30% of the febrile neutropenic episodes, an infectious agent is detected by conventional cultures. In this prospective study, the performance of broad-range PCR coupled with electrospray ionization time of flight mass spectrometry (PCR/ESI-MS) technology was compared to conventional blood cultures (BC) in a consecutive series of samples from high-risk hematology patients. In 74 patients, BC and a whole-blood sample for PCR/ESI-MS (Iridica BAC BSI; Abbott, Carlsbad, CA, USA) were collected at the start of each febrile neutropenic episode and, in case of persistent fever, also at day 5. During 100 different febrile episodes, 105 blood samples were collected and analyzed by PCR/ESI-MS. There was evidence of a bloodstream infection (BSI) in 36/105 cases (34%), based on 14 cases with both PCR/ESI-MS and BC positivity, 17 cases with BC positivity only, and 5 cases with PCR/ESI-MS positivity only. The sensitivity of PCR/ESI-MS was 45%, specificity was 93%, and the negative predictive value was 80% compared to blood culture. PCR/ESI-MS detected definite pathogens (Fusobacterium nucleatum and Streptococcus pneumoniae) missed by BC, whereas it missed both Gram-negative and Gram-positive organisms detected by BC. PCR/ESI-MS testing detected additional microorganisms but showed a low sensitivity (45%) compared to BC in neutropenic patients. Our results indicate a lower concordance between BC and PCR/ESI-MS in the neutropenic population than what has been previously reported in other patient groups with normal white blood cell distribution, and a lower sensitivity than other PCR-based methods.
journal_name
J Clin Microbioljournal_title
Journal of clinical microbiologyauthors
Desmet S,Maertens J,Bueselinck K,Lagrou Kdoi
10.1128/JCM.01066-16subject
Has Abstractpub_date
2016-10-01 00:00:00pages
2513-20issue
10eissn
0095-1137issn
1098-660Xpii
JCM.01066-16journal_volume
54pub_type
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章,多中心研究
doi:10.1128/JCM.37.7.2165-2169.1999
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
doi:10.1128/JCM.16.2.266-270.1982
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journal_title:Journal of clinical microbiology
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journal_title:Journal of clinical microbiology
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journal_title:Journal of clinical microbiology
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
doi:10.1128/jcm.41.10.4666-4670.2003
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
doi:10.1128/JCM.01632-15
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
doi:10.1128/JCM.12.5.690-694.1980
更新日期:1980-11-01 00:00:00
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
doi:10.1128/JCM.25.5.958-959.1987
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journal_title:Journal of clinical microbiology
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pub_type: 杂志文章,多中心研究
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
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journal_title:Journal of clinical microbiology
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
doi:10.1128/JCM.11.2.123-126.1980
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
doi:10.1128/JCM.35.1.292-294.1997
更新日期:1997-01-01 00:00:00
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
doi:10.1128/JCM.15.4.725-727.1982
更新日期:1982-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2006-06-01 00:00:00
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
doi:10.1128/jcm.41.12.5419-5428.2003
更新日期:2003-12-01 00:00:00
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
doi:10.1128/JCM.22.3.455-456.1985
更新日期:1985-09-01 00:00:00
abstract::Amplified fragment length polymorphism (AFLP) was employed as a genetic analysis tool for the study of the genetic relatedness of Mycobacterium avium subsp. paratuberculosis isolates harvested from bovine fecal samples and from bovine or human tissues. This analysis revealed genetic differences between these two isola...
journal_title:Journal of clinical microbiology
pub_type: 杂志文章
doi:10.1128/JCM.01123-10
更新日期:2011-06-01 00:00:00
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
doi:10.1128/JCM.25.4.729-731.1987
更新日期:1987-04-01 00:00:00