Denina Marco, Scolfaro Carlo, Colombo Sara, Calitri Carmelina, Garazzino Silvia, Barbui Anna Anna, Brossa Silvia, Tovo Pier-Angelo
Department of Pediatrics, Infectious Diseases Unit, Regina Margherita Children' s Hospital, University of Turin, Piazza Polonia 94, Turin, 10126, Italy.
Department of Virology and Microbiology, A.O. Città della Salute e della Scienza (Molinette), University of Turin, Turin, Italy.
Eur J Pediatr. 2016 Aug;175(8):1107-11. doi: 10.1007/s00431-016-2745-3. Epub 2016 Jun 29.
Sepsis is the major cause of morbidity and mortality in children, especially in immunocompromised patients, and a rapid identification of causative pathogen is strongly related with a better outcome. This prospective study analyzes the role of a multiplex real-time polymerase chain reaction in sepsis' etiological diagnosis. Magicplex(TM) Sepsis Real-Time tests were performed in tertiary Regina Margherita Children's Hospital (Turin, Italy), and the medical records of children who underwent a Magicplex test were prospectively evaluated. Results of the Magicplex test were compared with those of blood culture collected at a close time point. One hundred fifty Magicplex tests were collected from 89 patients (54 males and 35 females, age interquartile range: 2.6-12.1 years). Etiological definition was achieved in 60 bloodstream infection cases (40 %). In 32 episodes, Magicplex test alone gave a positive result, and blood culture alone permitted the etiological diagnosis in 5 septic episodes. Magicplex test allowed a 143 % increase in the diagnostic value of blood cultures.
These results suggest that molecular biology can be useful for rapid pathogen's identification also in children.
• Sepsis represents a major cause of morbidity and mortality in children. • Sepsis outcome is strongly related to rapid microbiological identification and prompt initiation of an appropriate chemotherapy. What is New: • This manuscript is the first that describes the use of Magicplex (TM) Sepsis Real-Time test in children. • The results suggest that molecular biology can be useful for rapid pathogen's identification also in children.
脓毒症是儿童发病和死亡的主要原因,尤其是在免疫功能低下的患者中,快速鉴定致病病原体与更好的治疗结果密切相关。这项前瞻性研究分析了多重实时聚合酶链反应在脓毒症病因诊断中的作用。在意大利都灵的玛格丽塔女王儿童医院进行了Magicplex(TM)脓毒症实时检测,并对接受Magicplex检测的儿童病历进行了前瞻性评估。将Magicplex检测结果与在相近时间点采集的血培养结果进行比较。从89名患者(54名男性和35名女性,年龄四分位间距:2.6 - 12.1岁)中收集了150份Magicplex检测样本。在60例血流感染病例(40%)中明确了病因。在32次发作中,仅Magicplex检测给出阳性结果,仅血培养在5次脓毒症发作中确诊病因。Magicplex检测使血培养的诊断价值提高了143%。
这些结果表明分子生物学在儿童快速病原体鉴定中也可能有用。
• 脓毒症是儿童发病和死亡的主要原因。• 脓毒症的治疗结果与快速微生物鉴定及及时开始适当的化疗密切相关。新内容:• 本手稿首次描述了Magicplex(TM)脓毒症实时检测在儿童中的应用。• 结果表明分子生物学在儿童快速病原体鉴定中也可能有用。