Detection of bacteraemia in critically ill patients using 16S rDNA polymerase chain reaction and DNA sequencing

2001 ◽  
Vol 27 (8) ◽  
pp. 1269-1273 ◽  
Author(s):  
James Sleigh ◽  
Ray Cursons ◽  
Mary La Pine
Keyword(s):  
Polymerase Chain Reaction ◽  
Dna Sequencing ◽  
16S Rdna ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Chain Reaction ◽  
Polymerase Chain

scholarly journals Positive nasal Staphylococcus aureus polymerase chain reaction assay is not sensitive in predicting concurrent or subsequent Staphylococcus aureus infection in critically ill patients

2020 ◽  
Vol 48 (3) ◽  
pp. 196-202
Author(s):  
Kalai C Kanagasingham ◽  
Kwok M Ho ◽  
J Owen Robinson
Keyword(s):  
Staphylococcus Aureus ◽  
Polymerase Chain Reaction ◽  
Critically Ill ◽  
Sensitivity And Specificity ◽  
Critically Ill Patients ◽  
High Specificity ◽  
Chain Reaction ◽  
Pcr Assay ◽  
Polymerase Chain ◽  
Mssa Infection

Staphylococcal infection is associated with significant morbidity and mortality in critically ill patients. Using data from 16,681 patients who had a nasal Staphylococcus aureus polymerase chain reaction (PCR) assay on admission to the intensive care unit (ICU) of Royal Perth Hospital between March 2006 and September 2016, this retrospective cohort study assessed whether nasal S. aureus colonisation on admission to an ICU was predictive of concurrent or subsequent S. aureus infections. Culture-proven S. aureus infections were identified using the hospital microbiology database. Of the 16,681 patients included, 565 (3.4%) had a positive methicillin-resistant S. aureus (MRSA) assay, 146 (0.9%) had a positive methicillin-sensitive S. aureus (MSSA) assay and eight (0.05%) had both positive MRSA and MSSA assays. Of those 565 patients with a positive MRSA PCR assay, 79 (13.8%) had concurrent or subsequent MRSA infections. Of those 146 patients with a positive MSSA PCR assay, only 5 (3.4%) had MSSA infection. The sensitivity and specificity for the MRSA PCR assay in predicting concurrent or subsequent MRSA infection were 72.7% (95% confidence intervals (CI) 63.4%–80.8%) and 97.0% (95% CI 96.8%–97.3%), respectively. The sensitivity and specificity for the MSSA PCR assay in predicting concurrent or subsequent MSSA infection were 3.3% (95% CI 1.1%–7.6%) and 99.1% (95% CI 98.9%–99.2%), respectively. Both nasal MRSA and MSSA PCR assays had a high specificity and negative predictive value in predicting MRSA and MSSA infections, respectively, suggesting that in centres without endemic S. aureus infections, a negative nasal MRSA or MSSA PCR assay may be useful to reduce unnecessary empirical antibiotic therapy against S. aureus.

Use of blood cultures in critically ill patients

2000 ◽  
Vol 20 (1) ◽  
pp. 45-50 ◽  
Author(s):  
R Henker
Keyword(s):  
Polymerase Chain Reaction ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
New Technology ◽  
Infectious Agent ◽  
Blood Cultures ◽  
Chain Reaction ◽  
Blood Samples ◽  
Polymerase Chain ◽  
Timely Treatment

Infection, bacteremia, and sepsis are frequent complications in critically ill patients. Ideally, the infectious agent is readily identified to facilitate timely treatment to promote the patient's recovery. Use of blood cultures is one method of identifying the pathogen. Fever is the primary indicator for obtaining blood samples for culture, but other indicators may be considered, depending on the patient's medical history and condition. Use of appropriate techniques when collecting blood samples for culture will decrease contamination and improve the likelihood of identification of the infectious agent. One new technique being tested for the identification of pathogens that cause bacteremia involves genetic technology and the polymerase chain reaction. The polymerase chain reaction is used to identify the DNA of bacteria that are present in the blood. Blood cultures may not always result in identification of the pathogen because the organism may not grow once placed in culture medium. This new method that uses the polymerase chain reaction may be more sensitive than blood cultures because it requires only DNA from bacteria. Although early studies have not been conclusive in terms of the benefits of this new technology, additional research will improve methods for identification of pathogens in critically ill patients.

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