Dierikx Thomas, Budding Andries, Bos Martine, van Laerhoven Henriëtte, van der Schoor Sophie, Niemarkt Hendrik, Benninga Marc, van Kaam Anton, Visser Douwe, de Meij Tim
Department of Pediatric Gastroenterology, Amsterdam UMC Location University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Amsterdam Gastroenterology Endocrinology Metabolism, 1105 AZ Amsterdam, The Netherlands.
Microorganisms. 2023 Apr 7;11(4):960. doi: 10.3390/microorganisms11040960.
Delay in the time-to-positivity of a peripheral blood culture (PBC), the gold standard for early onset neonatal sepsis (EOS) diagnosis, has resulted in excessive use of antibiotics. In this study, we evaluate the potential of the rapid Molecular Culture (MC) assay for quick EOS diagnosis. In the first part of this study, known positive and spiked blood samples were used to assess the performance of MC. In the in vivo clinical study, the second part of this study, all infants receiving antibiotics for suspicion of EOS were included. At initial EOS suspicion, a blood sample was collected for PBC and MC. MC was able to detect bacteria present in the spiked samples even when the bacterial load was low. In the clinical study, MC was positive in one infant with clinical EOS () that was not detected by PBC. Additionally, MC was positive in two infants without clinical sepsis ( and multiple species), referred to as contamination. The other 37 samples were negative both by MC and PBC. MC seems to be able to detect bacteria even when the bacterial load is low. The majority of MC and PBC results were comparable and the risk for contamination and false positive MC results seems to be limited. Since MC can generate results within 4 h following sampling compared with 36-72 h in PBC, MC may have the potential to replace conventional PBC in EOS diagnostics in order to guide clinicians on when to discontinue antibiotic therapy several hours after birth.
外周血培养（PBC）是早发型新生儿败血症（EOS）诊断的金标准，但培养结果出现阳性的时间延迟，导致了抗生素的过度使用。在本研究中，我们评估了快速分子培养（MC）检测在快速诊断EOS方面的潜力。在本研究的第一部分，使用已知阳性和加标的血样来评估MC的性能。在本研究的第二部分即体内临床研究中，纳入了所有因疑似EOS而接受抗生素治疗的婴儿。在最初怀疑患有EOS时，采集血样进行PBC和MC检测。即使细菌载量很低，MC也能够检测出加标样本中存在的细菌。在临床研究中，一名临床诊断为EOS但PBC未检测出的婴儿，其MC检测呈阳性。此外，两名无临床败血症（以及多种菌种）的婴儿的MC检测呈阳性，这被称为污染。其他37个样本的MC和PBC检测结果均为阴性。即使细菌载量很低，MC似乎也能够检测出细菌。大多数MC和PBC的结果具有可比性，污染风险和MC假阳性结果似乎有限。由于与PBC的36 - 72小时相比，MC在采样后4小时内就能得出结果，因此MC可能有潜力在EOS诊断中取代传统的PBC，以便指导临床医生在出生后数小时何时停止抗生素治疗。
