The Consortium of the Intercomarcal Laboratory of the Alt Penedès, Department of Microbiology, Vilafranca del Penedès, Spain.
Department of Pneumology, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Networked Biomedical Research Center for Respiratory Diseases (CIBERES), University of Barcelona, Barcelona, Spain.
Front Cell Infect Microbiol. 2019 Mar 12;9:56. doi: 10.3389/fcimb.2019.00056. eCollection 2019.
Sepsis is a serious health condition worldwide, affecting more than 30 million people globally each year. Blood culture (BC) is generally used to diagnose sepsis because of the low quantity of microbes occurring in the blood during such infections. However, ~50% of bloodstream infections (BSI) give negative BC, this figure being higher for sepsis, which delays the start of appropriate antimicrobial therapy. This prospective study evaluated a multiplex real-time polymerase chain reaction, the Magicplex Sepsis test (MP), for the detection of pathogens from whole blood, comparing it to routine BC. We analyzed 809 blood samples from 636 adult patients, with 132/809 (16.3%) of the samples positive for one or more relevant microorganism according to BC and/or MP. The sensitivity and specificity of MP were 29 and 95%, respectively, while the level of agreement between BC and MP was 87%. The rate of contaminated samples was higher for BC (10%) than MP (4.8%) ( < 0.001). Patients with only MP-positive samples were more likely to be on antimicrobial treatment (47%) than those with only BC-positive samples (18%) ( = 0.002). In summary, the MP test could be useful in some clinical setting, such as among patients on antibiotic therapy. Nevertheless, a low sensitivity demonstrated impairs its use as a part of a routine diagnostic algorithm.
败血症是一种严重的全球健康问题,每年影响全球超过 3000 万人。由于此类感染期间血液中微生物的数量较低,因此通常使用血培养(BC)来诊断败血症。然而,约有 50%的血流感染(BSI)BC 结果为阴性,败血症的这一比例更高,这会延迟开始适当的抗菌治疗。本前瞻性研究评估了一种用于检测全血病原体的多重实时聚合酶链反应,即 Magicplex 败血症测试(MP),并将其与常规 BC 进行比较。我们分析了来自 636 名成年患者的 809 份血液样本,根据 BC 和/或 MP,有 132/809(16.3%)份样本对一种或多种相关微生物呈阳性。MP 的灵敏度和特异性分别为 29%和 95%,而 BC 和 MP 之间的一致性水平为 87%。BC 的污染样本率(10%)高于 MP(4.8%)(<0.001)。仅 MP 阳性样本的患者更有可能接受抗菌治疗(47%),而仅 BC 阳性样本的患者(18%)(=0.002)。总之,MP 测试在某些临床环境中可能有用,例如在接受抗生素治疗的患者中。然而,较低的灵敏度限制了其作为常规诊断算法一部分的使用。