Randomized controlled clinical trial evaluating multiplex polymerase chain reaction for pathogen identification and therapy adaptation in critical care patients with pulmonary or abdominal sepsis

Objective To determine whether a multiplex polymerase chain reaction (PCR)-based test could reduce the time required for initial pathogen identification in patients in an intensive care unit (ICU) setting. Methods This double-blind, parallel-group randomized controlled trial** enrolled adults with s...

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Bibliographic Details
Published in:Journal of international medical research 2015-06, Vol.43 (3), p.364-377
Main Authors: Tafelski, Sascha, Nachtigall, Irit, Adam, Thomas, Bereswill, Stefan, Faust, Jana, Tamarkin, Andrey, Trefzer, Tanja, Deja, Maria, Idelevich, Evgeny A, Wernecke, Klaus-Dieter, Becker, Karsten, Spies, Claudia
Format: Article
Language:English
Subjects:
Adult
Bacterial Typing Techniques
Critical Care
Double-Blind Method
Gastrointestinal Diseases - diagnosis
Gastrointestinal Diseases - microbiology
Humans
Molecular Diagnostic Techniques - methods
Multiplex Polymerase Chain Reaction - methods
Mycological Typing Techniques
Respiratory Tract Infections - diagnosis
Respiratory Tract Infections - microbiology
Sepsis - diagnosis
Sepsis - microbiology
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Summary:Objective To determine whether a multiplex polymerase chain reaction (PCR)-based test could reduce the time required for initial pathogen identification in patients in an intensive care unit (ICU) setting. Methods This double-blind, parallel-group randomized controlled trial** enrolled adults with suspected pulmonary or abdominal sepsis caused by an unknown pathogen. Both the intervention and control groups underwent the standard blood culture (BC) testing, but additional pathogen identification, based on the results of a LightCycler® SeptiFast PCR test, were provided in the intervention group. Results The study enrolled 37 patients in the control group and 41 in the intervention group. Baseline clinical and demographic characteristics were similar in both groups. The PCR-based test identified a pathogen in 10 out of 41 (24.4%) patients in the intervention group, with a mean duration from sampling to providing the information to the ICU of 15.9 h. In the control group, BC results were available after a significantly longer period (38.1 h). Conclusion The LightCycler® SeptiFast PCR test demonstrated a significant reduction in the time required for initial pathogen identification, compared with standard BC.
ISSN:0300-0605
1473-2300
DOI:10.1177/0300060514561135