LightCycler SeptiFast technology in patients with solid malignancies: clinical utility for rapid etiologic diagnosis of sepsis
© BioMed Central Ltd 2012
Published: 17 January 2012
Recent development of molecular tools for pathogen detection introduced the possibility of early targeted antimicrobial treatment that, in turn, may improve the outcome of patients with sepsis .
We retrospectively evaluated 54 results of the SeptiFast test from patients with solid malignancy admitted to the ICU between June 2009 and August 2011. Specimens from suspected bloodstream infection were analyzed using LightCycler SeptiFast (Roche Molecular Diagnostics, Prague, Czech Republic) according to the manufacturer's instructions and evaluated in comparison with blood culture results obtained from blood sampled no longer than 24 hours before or after sampling for SeptiFast. Blood culturing and identification were performed according to the routine diagnostic procedures. The total number of complementary blood cultures analyzed was 85. Consistently, negative results from SeptiFast and blood culture were obtained in 21 (39%) cases.
The turnaround time for blood culture analysis is 24 to 48 hours. The workflow in our laboratory allows SeptiFast analysis every working day during a day shift. In such conditions, the turnaround time of SeptiFast results for samples delivered to the laboratory on a workday between 7 am and 2 pm was as follows: 100% of samples, 10 hours; 97% of samples, 8 hours; 59% of samples, 6 hours. The average turnaround time for tests performed with manual DNA isolation was 6 hours 11 minutes; by implementation of automated isolation of DNA using the MagNA Pure Compact System , the mean turnaround time was shortened to 5 hours 17 minutes.
In conclusion, detection of pathogen by the LightCycler SeptiFast system is generally not inferior to the results from blood culture. The added value of multiplex DNA amplification-based pathogen detection is the shorter test turnaround time and probably the increased true sensitivity of detection of certain pathogens. Moreover, in clinical settings pathogen detection may be required after an antibiotic administration; in such conditions, cultivation independent methods are of clear benefit .
The authors received a contribution for the reagents, equipment from Roche Diagnostics for this project, and were supported by the European Regional Development Fund and the State budget of the Czech Republic for RECAMO (CZ.1.05/2.1.00/03.0101).
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