Vietnamese-German Center for Medical Research (VG-CARE), 108 Military Central Hospital, Hà Nội, Vietnam.
Centre for Genetic Consultation and Cancer Screening, 108 Military Central Hospital, Hà Nội, Vietnam.
Sci Rep. 2019 Sep 20;9(1):13663. doi: 10.1038/s41598-019-50150-y.
Sepsis is an acute, often fatal syndrome that requires early diagnosis and proper treatment. Blood culture (BC) is the gold standard for the identification of pathogens, however it has marked limitations, including that it is time-consuming (delaying treatment) and can only detect microbes that readily grow under culture conditions. Alternatively, non-culture-based methodologies like polymerase chain reaction (PCR) are faster but also have limitations; e.g., the reaction is often inhibited by the abundance of human DNA and thus can only detect limited known target pathogens. In our previous publication, we have demonstrated a proof-of-concept of a simple pre-analytical tool to remove human DNA from patients' blood specimens, hence allowing downstream PCRs to detect rare bacterial genetic materials. In the current study, we reported a better performance of a novel prototype diagnosis kit named Sepsis@Quick that combines human DNA removal step with real-time PCRs compared to blood-culture for identifying sepsis causative bacteria. Our data showed that Sepsis@Quick is superior to blood culture in which the novel diagnostic kit could identify more pathogens and even polymicrobial infection, faster and less influenced by the empirical administration of broad spectrum antibiotic therapy (single administration or combination of cephalosporin III and fluoroquinolon). Additionally, for the first time, we demonstrated that positive results achieved by Sepsis@Quick are significantly associated with a reduction of sepsis-related mortality.
脓毒症是一种急性的、常常致命的综合征，需要早期诊断和适当的治疗。血培养（BC）是鉴定病原体的金标准，但它有明显的局限性，包括耗时（延迟治疗），并且只能检测到在培养条件下容易生长的微生物。相比之下，非培养为基础的方法，如聚合酶链反应（PCR），速度更快，但也有局限性；例如，反应常常受到大量人 DNA 的抑制，因此只能检测到有限的已知目标病原体。在我们之前的出版物中，我们已经证明了一种简单的预分析工具的概念验证，可以从患者的血液样本中去除人 DNA，从而允许下游 PCR 检测罕见的细菌遗传物质。在当前的研究中，我们报告了一种名为 Sepsis@Quick 的新型原型诊断试剂盒的更好性能，该试剂盒将人 DNA 去除步骤与实时 PCR 相结合，与血液培养相比，用于鉴定脓毒症的致病细菌。我们的数据表明，Sepsis@Quick 优于血培养，新型诊断试剂盒可以更快地识别更多的病原体，甚至是混合感染，并且受经验性广谱抗生素治疗（单一给药或头孢菌素 III 和氟喹诺酮类药物联合给药）的影响较小。此外，我们首次证明，Sepsis@Quick 的阳性结果与脓毒症相关死亡率的降低显著相关。
