Detection of Candidaemia by Polymerase Chain Reaction in Intensive Care Unit Patients who Developed Central Line Associated Blood Stream Infections

2013 ◽  
Vol 22 (1) ◽  
pp. 117-124
Author(s):  
Abeer Ezzat El-Sayed ◽  
Samia Ragab Elazab
Keyword(s):  
Intensive Care Unit ◽  
Polymerase Chain Reaction ◽  
Intensive Care ◽  
Blood Stream ◽  
Central Line ◽  
Chain Reaction ◽  
Blood Stream Infections ◽  
Polymerase Chain

Central Line-Associated Blood Stream Infection in the Critically Ill Trauma Patient

2011 ◽  
Vol 77 (8) ◽  
pp. 1038-1042 ◽  
Author(s):  
Jason W. Smith ◽  
Michael Egger ◽  
Glen Franklin ◽  
Brian Harbrecht ◽  
J. David Richardson
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Central Venous Catheter ◽  
Injury Severity ◽  
Venous Catheter ◽  
Blood Stream ◽  
Central Line ◽  
Central Venous ◽  
Blood Stream Infections ◽  
Sterile Technique

Blood stream infections in the critically ill are a common cause of morbidity. Strict adherence to sterile technique can reduce central line-associated blood stream infections (CLBSIs) and has become a quality improvement measure. We did a retrospective review of 6,014 trauma admissions representing 10,370 catheter days. CLBSI was defined as a positive blood culture with central venous access without evidence of other infectious sources. Thirty-five CLBSIs were identified in the study period (3.26/1,000 line days). The average Injury Severity Score was 32, the average intensive care unit stay was 24 days, and the average overall length of stay was 34 days, which is higher than that of nonCLBSI patients. In 25/35 cases, there was a break in sterile technique during central venous catheter placement (71%). Of the 25 cases, 16 of them were performed in the intensive care unit (64%), five in the operating room (20%), and four in the emergency department (16%). Twenty of the 35 patients with CLBSI (57%) had a total of 24 infections, a 2-fold increase in infectious complications for a given Injury Severity Score. Seventeen (17) of the 25 “dirty” central lines (68%) were changed within 24 hours in an effort to reduce the risk of CLBSI without success. A large percentage of CLBSI can be traced to the initial placement of a central venous line under less than ideal sterile technique. Changing a line within 24 hours may not be sufficient to reduce the risk of CLBSI. Every effort should be made to adhere to proper sterile technique while placing central venous catheter.

scholarly journals Molecular Species Identification of Candida from Blood Samples of Intensive Care Unit Patients by Polymerase Chain Reaction – Restricted Fragment Length Polymorphism

2012 ◽  
Vol 4 (01) ◽  
pp. 001-004 ◽  
Author(s):  
Ramraj Vijayakumar ◽  
Sidhartha Giri ◽  
Anupma Jyoti Kindo
Keyword(s):  
Intensive Care Unit ◽  
Polymerase Chain Reaction ◽  
Intensive Care ◽  
Length Polymorphism ◽  
Fragment Length Polymorphism ◽  
Chain Reaction ◽  
Candida Spp ◽  
Blood Samples ◽  
Pcr Rflp ◽  
Polymerase Chain

ABSTRACT Introduction: Candida spp is an emerging cause of blood stream infections worldwide. Delay in speciation of Candida isolates by conventional methods and resistance to antifungal drugs (especially fluconazole, amphotericin B, etc.) in various Candida species are some of the factors responsible for the increase in morbidity and mortality due to candidemia. So, the rapid detection and identification of Candida isolates from blood is very important for the proper management of patients having candidemia. Materials and Methods: In this study, we have used polymerase chain reaction (PCR) - restriction fragment length polymorphism (RFLP) as a method for the speciation of Candida isolates from blood samples of intensive care unit (ICU) patients. PCR was used to amplify the ITS-1 and ITS-2 regions of Candida spp using universal primers ITS-1 and ITS-4. The amplified product was digested using Msp I restriction enzyme by RFLP. Results and Discussion: The method PCR-RFLP helped in identifying five medically important Candida spp (C. tropicalis, C. albicans, C. parapsilosis, C. krusei and C. glabrata) from blood. This method is rapid, reliable, easy and cost-effective and can be used in routine laboratory diagnostics for the rapid identification of Candida isolates from blood. Conclusion: PCR-RFLP is an easy, rapid and highly valuable tool which can be used in routine diagnostic laboratories to speciate Candida isolates obtained from blood. This rapid method of speciation will help clinicians to decide on empirical therapy in candidemia cases before antifungal susceptibility results are available.

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