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Volume 17 Supplement 4

Sepsis 2013

Open Access

Rapid molecular test (SeptiFast®) reduced time for adjustment of antibiotic treatment in comparison with conventional blood cultures in critically ill sepsis patients: a randomized controlled clinical trial (preliminary results)

  • Cristhieni Rodrigues1,
  • Mirlane Silva dos Santos2,
  • Helio Hehl Caiaffa Filho2,
  • Cecilia Eugênia Charbel2,
  • Luciane de Carvalho Sarahyba da Silva2,
  • Flávia Rossi3,
  • Maria Renata Gomes Franco3,
  • Rinaldo Focaccia Siciliano1 and
  • Tânia Mara Varejão Strabelli1
Critical Care201317(Suppl 4):P26

https://doi.org/10.1186/cc12926

Published: 5 November 2013

Keywords

Public HealthIntervention GroupBlood SampleAdult PatientEarly Detection

Background

Sepsis is the main cause of death in ICUs all over the world. Early detection of the pathogen is essential for appropriate antimicrobial treatment.

Materials and methods

To evaluate the reduction in time of antimicrobial adjustment therapy in patients with sepsis comparing a rapid molecular test (SeptiFast®) with conventional blood cultures, a randomized controlled clinical trial was conducted between October 2012 and May 2013 in a cardiology hospital. Adult patients staying more than 48 hours in hospital with clinical suspicion of sepsis were included in the study. Blood samples were collected for cultures (BacT/ALERT®) and Septifast® test immediately prior to initiation of antibiotic therapy. Patients were allocated into two groups. In the Intervention Group (GI), Septifast® results were communicated to the medical researcher and antimicrobials were adjusted. In the Control Group (GII), Septifast® results were not informed and therapy adjustment was based on the blood culture. Registered in Clinical trials.gov (NCT 01450358).

Results

Forty-six patients were included, 17 in GI and 29 in GII. Key data are shown in Table 1. In GI therapy adjustment was done in 580 minutes compared with 3,007 minutes in GII (P = 0.004).
Table 1

Distribution of characteristics in the two groups

 

Intervention group (n= 17)

Control group (n= 29)

Pvalue

Age (years)

63 (46 to 75)

66 (39 to 85)

0.340

Gender (female)

5 (30%)

10 (34%)

0.999

Hospital stay (mean, days)

32 (9 to 118)

31 (3 to 112)

0.632

APACHE II (mean)

17 (8 to 29)

17 (8 to 29)

0.730

Ejection fraction <40%

8 (47%)

17 (58%)

0.545

Receiving antibiotics prior to study

11 (65%)

11 (38%)

0.126

Septic shock

9 (53%)

16 (55%)

0.999

Patients with adjustment therapy based on SeptiFast®

6 (35%)

-

 

Patients with adjustment therapy based on blood culture

-

7 (21%)

 

Mean time (minutes) of adjustment therapy

580

3,007

0.004

Pathogens detected in SeptiFast®

P. aeruginosa (2), K. pneumonia/oxytoca (1), E. aerogenes/cloacae (1), S. marcescens (1), A. baumanii (1)

-

 

Pathogens detected in blood culture

-

S. aureus (4), K. pneumonia (2), M. morganii (1)

 

28-day mortality

9 (53%)

17 (59%)

0.765

Conclusions

The rapid molecular test (SeptiFast®) reduced the time for adjustment of antibiotic treatment in comparison with conventional blood cultures in critically ill sepsis patients.

Authors’ Affiliations

(1)
Infection Control Unit, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil
(2)
Molecular Biology Branch, Central Laboratory Division, University of Sao Paulo Medical School, Sao Paulo, Brazil
(3)
Central Laboratory Division, University of Sao Paulo Medical School, Sao Paulo, Brazil

Copyright

© Rodrigues et al.; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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