Table 2 Current molecular techniques for detection of bloodstream infection, performed directly on whole blood
From: Bench-to-bedside review: Rapid molecular diagnostics for bloodstream infection - a new frontier?
Assay/manufacturer | Technique | Anti-microbial resistance genes | Detectable pathogens | Detection limit(CFU/ml) | Turn- around time (h) | Costs equipment/test and supplies | Sensitivity/specificity |
|---|---|---|---|---|---|---|---|
SepsiTest (Molzym, Germany) | Broad-range PCR + sequencing | None | >300 different pathogens | 20-40 for S. aureus | 8-12 | $$$/+++ | 82%/86-90% |
Vyoo (SIRS-Lab, Germany) | Multiplex PCR + gel electrophoresis | mec, vanA, vanB, vanC, bla SHV | S. pyogenes, S. pneumoniae, S. agalactiae, viridans-group streptococci species, S. aureus, CoNS, E. faecalis, E. faecium, Clostridium perfringens, Bacillus cereus, E. coli, E. aerogenes, E.cloacae, K. oxytoca, K. pneumoniae, P. mirabilis, S. marcescens, Morganella morganii, P. aeruginosa, S. maltophilia, A. baumannii, Burkholderia cepacia, H. in uenzae, Neisseria meningitidis, Bacteroides fragilis, Prevotella buccae, P. melaninogenica, P.intermedia, C. albicans, C. parapsilosis, C. tropicalis, C. glabrata, C.krusei, Aspergillus fumigatus | 3-10 | 8 | $$$/++ | NA/NA |
LightCycler SeptiFast(Roche, Germany) | Multiplex real-time PCR | mecA | S. aureus, CoNS, Streptococcus pneumoniae, Streptococcus spp. (S. pyogenes, S. agalactiae, S. mitis), E. faecium, E. faecalis, E. coli, K.pneumoniae, K. oxytoca, Proteus mirabilis, E. cloacae, E. aerogenes, Serratia marcescens, Acinetobacter baumannii, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, C. albicans, C. tropicalis, C. parapsilosis, C. glabrata, C. krusei, Aspergillus fumigatus | 3-30 | 6 | $$/+++ | 60-95%/74-99%a |
Plex-ID (Abbott , USA) | Multiplex PCR detected by electrospray ionization mass spectrometry | mecA, vanA, vanB, vanC, bla KPC | Multiple pathogens and bioagents, including Yersinia pestis, Bacillus anthracis. Separate dedicated assays for viruses or yeasts/fungi | NA | 8-12 | $$$$/++ | NA/NA |
VAPChip [106] (Eppendorf Array Technologies, Belgium) | Multiplex PCR + hybridization on a cartridge-containing microarray | bla TEM , bla SHV, bla CTX-M, carbapenemasesb, mecA | S. aureus, S. pneumoniae, E. coli, K. pneumoniae, K. oxytoca, E.cloacae, E. aerogenes, S. marcescens, A. baumannii, P. aeruginosa, S. maltophilia, Haemophilus influenzae, Legionella pneumophila | >10 | 5-8 | NA | NA/NA |
MagicPlex (SeeGene, Korea) | Multiplex real-time PCR | vanA, VanB, mecA | 73 Gram-positive (30 Staphylococcus spp., 40 Streptococcus spp., 3 Enterococcus spp.), Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia, Serratia marcescens, Bacteroides fragilis, Salmonella typhi, Klebsiella oxytoca, Proteus mirabilis, E. coli, E. cloacae, E. aerogenes, C. albicans, C. tropicalis, C.parapsilosis, C. glabrata, C. krusei, Aspergillus fumigatus. Separate dedicated assays for viruses | NA | 3-4 | NA | NA/NA |