Clinical impact of a PCR-based assay for pathogen detection in critically ill patients with evidence of infection
© BioMed Central Ltd 2009
Published: 11 November 2009
Blood cultures are often negative even in patients with clinical signs of severe sepsis. Furthermore, the long time to result of culture-based methods does not allow the results to guide empiric antimicrobial therapy. PCR-based pathogen detection promises a higher rate of positivity and a faster time to result.
To report the performance of PCR-based pathogen detection compared with blood culture in ICU patients with evidence of infection, and the impact of this test on the antimicrobial therapy.
Patients treated on an interdisciplinary ICU were included into this observational study if a blood culture (BC) was drawn on discretion of the treating physician. Blood cultures and EDTA-blood were taken by sterile venous puncture. The EDTA-blood was processed with a PCR-based assay (VYOO®; SIRS-Lab GmbH, Jena, Germany), which detects a panel of 34 bacterial and six fungal pathogens as well as five antibiotic resistances. Data are given as median and interquartile range.
The PCR-based assay resulted in a considerably higher amount of positive results within a shorter time to result than the BC in this group of high-risk patients with evidence of infection. These data demonstrate that the shorter time to result may guide adjustment of antimicrobial therapy earlier than culture-based methods. Further studies are necessary to prospectively investigate the impact of the PCR technique on antimicrobial therapy and infection control.