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Title: Rapid Diagnosis of Staphylococcal Catheter-Related Bacteraemia in Direct Blood Samples by Real-Time PCR
Author: Zboromyrska, Yuliya
Calle, Cristina de la
Soto, Marcelo
Sampietro-Colom, Laura
Soriano Viladomiu, Alex
Álvarez Martínez, Míriam
Almela, Manel
Marco Reverté, Francesc
Arjona, Ruth
Cobos-Trigueros, Nazaret
Morata, Laura
Mensa Pueyo, Josep
Martínez, José Antonio (Martínez Martínez)
Mira, Aurea
Vila Estapé, Jordi
Keywords: Catèters
Infeccions per estafilococs
Reacció en cadena de la polimerasa
Staphylococcal infections
Polymerase chain reaction
Issue Date: 29-Aug-2016
Publisher: Public Library of Science (PLoS)
Abstract: Catheter-related bacteremia (CRB) is an important cause of morbidity and mortality among hospitalized patients, being staphylococci the main etiologic agents. The objective of this study was to assess the use of a PCR-based assay for detection of staphylococci directly from blood obtained through the catheter to diagnose CRB caused by these microorganisms and to perform a cost-effectiveness analysis. A total of 92 patients with suspected CRB were included in the study. Samples were obtained through the catheter. Paired blood cultures were processed by standard culture methods and 4 ml blood samples were processed by GeneXpert-MRSA assay for the detection of methicillin-susceptible (MSSA) or methicillin-resistant (MRSA) Staphylococcus aureus, and methicillin-resistant coagulase-negative staphylococci (MR-CoNS). Sixteen CRB caused by staphylococci were diagnosed among 92 suspected patients. GeneXpert detected 14 out of 16 cases (87.5%), including 4 MSSA and 10 MR-CoNS in approximately 1 hour after specimen receipt. The sensitivity and specificity of GeneXpert were 87.5% (CI 95%: 60.4-97.8) and 92.1% (CI 95%: 83-96.7), respectively, compared with standard culture methods. The sensitivity of GeneXpert for S. aureus was 100%. Regarding a cost-effectiveness analysis, the incremental cost of using GeneXpert was of 31.1euro per patient while the incremental cost-effectiveness ratio of GeneXpert compared with blood culture alones was about 180euro per life year gained. In conclusion, GeneXpert can be used directly with blood samples obtained through infected catheters to detect S. aureus and MR-CoNS in approximately 1h after sampling. In addition, it is cost-effective especially in areas with high prevalence of staphylococcal CRB.
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It is part of: PLoS One, 2016, vol. 11, num. 8, p. e0161684
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ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (ISGlobal)
Articles publicats en revistes (Fonaments Clínics)

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