BMC Microbiology | |
Beacon-based (bbFISH®) technology for rapid pathogens identification in blood cultures | |
Carla Fontana2  Giuliana Lo Cascio1  Martina Parisato1  Christina Sakarikou2  | |
[1] Department of Pathology and Diagnostic, Servizio Microbiologia e Virologia-Azienda Ospedaliera Universitaria Integrata, Verona, P.le Scuro, 10-37134 Verona, Italy;Clinical Microbiology Laboratories, Foundation Polyclinic Tor Vergata, V.le Oxford 81, 00133 Rome, Italy | |
关键词: hemoFISH; Beacon-based FISH; Rapid test; Sepsis; | |
Others : 1141349 DOI : 10.1186/1471-2180-14-99 |
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received in 2013-03-30, accepted in 2014-02-04, 发布年份 2014 | |
【 摘 要 】
Background
Diagnosis and treatment of bloodstream infections (BSI) are often hampered by the delay in obtaining the final results of blood cultures. Rapid identification of pathogens involved in BSI is of great importance in order to improve survival of septic patients. Beacon-based fluorescent in situ hybridization (hemoFISH® Gram positive and hemoFISH® Gram negative test kits, miacom diagnostics GmbH Düsseldorf, Germany) accelerates the identification of most frequent bacterial pathogens of sepsis.
Results
In this study a total of 558 blood culture (377 blood culture positive and 181 negative) were tested with the hemoFISH® method and the results were evaluated in comparison with the traditional culture based methods. The overall sensitivity and specificity of the hemoFISH® tests were 94.16% and 100%, while, the PPV and NPV were 100 and 89.16%, respectively. As the hemoFISH® results were obtained within 45 mins, the time difference between the final results of the traditional culture method and the hemoFISH® assay was about two days.
Conclusions
Considering the good sensitivity and specificity of the hemoFISH® assays as well as the significant time saving in obtaining the final results (p-value 0.0001), the introduction of the system could be rialable in the microbiology laboratories, even alongside the traditional systems.
【 授权许可】
2014 Sakarikou et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20150327025312434.pdf | 208KB | download |
【 参考文献 】
- [1]Cohen J: The immunopathogenesis of sepsis. Nat 2002, 420:885-891.
- [2]Hotchkiss RS, Karl I: The pathophysiology and treatment of sepsis. New Engl J Med 2003, 348:138-150.
- [3]Lever A, MacKenzie I: Sepsis: definition, epidemiology and diagnosis. BMJ 2007, 335:879-883.
- [4]Calandra T, Cohen J: The international sepsis forum consensus conference on definitions of infection in the intensive care unit. Crit Care Med 2005, 33:1538-1548.
- [5]Dellinger R, Levy M, Carlet J, Bion J, Parker M, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL: Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 2008, 34:17-60.
- [6]Health Protection Agency: Investigation of blood cultures (for organisms other than Mycobacterium species). National Standard Method.London, Standards Unit 2012, B37:6.1. Available online at http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317132857861 webcite
- [7]Kollef M, Sherman G, Ward S, Fraser V: Inadequate antimicrobial treatment of infections: a risk factor of hospital mortality among critically ill patients. Chest 1999, 115:462-474.
- [8]Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, Suppes R, Feinstein D, Zanotti S, Taiberg L, Gurka D, Kumar A, Cheang M: Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 2006, 34:1589-1596.
- [9]Stefani S: Diagnostic techniques in bloodstream infections: where are we going? Int Antimicrob Agents 2009, 34:9-12.
- [10]Moter A, Göbel UB: Fluorescence in situ hybridization (FISH) for direct visualization of microorganisms. J Microb Meth 2000, 41:85-112.
- [11]Mallmann C, Siemoneit S, Schmiedel D, Petrich A, Gescher DM, Halle E, Musci M, Hetzer R, Göbel UB, Moter A: Fluorescence in situ hybridization to improve the diagnosis of endocarditis: a pilot study. Clin Microbiol Infect 2010, 16:767-773.
- [12]Poppert S, Essig A, Stoehr B, Steingruber A, Wirths B, Juretschko S, Reischl U, Wellinghausen N: Rapid diagnosis of bacterial meningitis by real-time PCR and fluorescence in situ hybridization. J Clin Microbiol 2005, 43:3390-3397.
- [13]Splettstoesser WD, Seibold E, Zeman E, Trebesius K, Podbielski A: Rapid differentiation of Francisella species and subspecies by fluorescent in situ hybridization targeting the 23S rRNA. BMC Microbiol 2010, 10:72. BioMed Central Full Text
- [14]Wellinghausen N, Nöckler K, Sigger A, Bartel M, Essig A, Poppert S: Rapid detection of Brucella spp. in blood cultures by fluorescence in situ hybridization. J Clin Microbiol 2006, 44:1828-1830.
- [15]Wellinghausen N, Köthe J, Wirths B, Sigge A, Poppert S: Superiority of molecular techniques for identification of Gram-negative, oxidase-positive rods, including morphologically non typical Pseudomonas aeruginosa, from patients with cystic fibrosis. J Clin Microbiol 2005, 43:4070-4075.
- [16]Goddard KA, Townsend R, Ridgway E: Rapid diagnosis of intrapartum group B streptococcal carriage by fluorescent in situ hybridization. J Clin Pathol 2007, 60:842-843.
- [17]Amman RI, Krumholz L, Stahl DA: Fluorescent oligonucleotide probing of whole cells for determinative, phylogenetic, and environmental studies in microbiology. J Bacteriol 1990, 172:762-770.
- [18]Tyagi S, Kramer FR: Molecular Beacons: Probes that fluoresce upon hybridization. Nat Biotechnol 1996, 14:303-308.
- [19]Beckmann SE, Diekema DJ, Chapin KC, Doern GV: Effects of rapid detection of bloodstream infections on length of hospitalization and hospital charges. J Clin Microbiol 2003, 41:3119-3125.
- [20]Barenfanger J, Graham DR, Kolluri L, Sangwan G, Lawhorn J, Drake CA, Verhulst SJ, Peterson R, Moja LB, Ertmoed MM, Moja AB, Shevlin DW, Vautrain R, Callahan CD: Decreased mortality associated with prompt Gram staining of blood cultures. Am J Clin Pathol 2008, 130:870-6.
- [21]Hawkins RC: Laboratory turnaround time. Clin Biochem Rev 2007, 28:179-194.
- [22]Steindel SJ, Howanitz PJ: Physician satisfaction and emergency department laboratory test turnaround time. Arch Pathol Lab Med 2001, 125:863-71.
- [23]Hilborne LH, Oye RK, McArdle JE, Repinski JA, Rodgerson DO: Evaluation of stat and routine turnaround times as a component of laboratory quality. Am J Clin Pathol 1989, 91:331-335.
- [24]Dark P, Dunn G, Chadwick P, Young D, Bentley A, Carlson G, Warhurst G: The clinical diagnostic accuracy of rapid detection of healthcare-associated bloodstream infection in intensive care using multi patho genereal-time PCR technology. BMJ Open 2011, 1:e000181.
- [25]Kaleta EJ, Clark AE, Cherkaoui A, Wysocki VH, Ingram EL, Schrenzel J, Wolk DM: Comparative analysis of PCR-electrospray ionization/mass spectrometry (MS) and MALDI-TOF/MS for the identification of bacteria and yeast from positive blood-culture bottles. Clin Chem 2011, 57:1057-67.
- [26]Christner M, Rohde H, Wolters M, Sobottka I, Wegscheider K, Aepfelbacher M: Rapid identification of bacteria from positive blood culture bottles by use of matrix-assisted laser desorption-ionization time of flightmass spectrometry fingerprinting. J Clin Microbiol 2010, 48:1584-91.
- [27]Valenstein P: Laboratory turnaround time. Am J Clin Pathol 1996, 105:676-688.
- [28]Valenstein PN, Emancipator K: Sensitivity, specificity, and reproducibility of four measures of laboratory turnaround time. Am J Clin Pathol 1989, 92:613-618.
- [29]Travers A: The regulation of promoter selectivity in eubacteria. In DNA-Protein Interactions. New York: Chapman and Hall; 1993:109-129. http://link.springer.com/chapter/10.1007%2F978-94-011-1480-6_5 webcite
- [30]Fontana C, Favaro M, Minelli S, Bossa MC, Altieri A, Favalli C: A novel culturing system for fluid samples. Med Sci Monit 2009, 15:BR55-BR60.