Cost and mortality prediction using polymerase chain reaction pathogen detection in sepsis: evidence from three observational trials

Table 3 Characteristics of 12 non-survivors observed in 29 inadequately treated PCR+ patients

Age	Co-morbidity	Infectious focus	PCR+ pathogen ^a	# days gainable ^b	Evidence for PCR+ relevance ^c
					BC+	Other test
74	Pleural lesion	Peritonitis	Aspergillus, Candida	4	Candida	Aspergillus antigen+
79	Decompensated heart (right side)	Cholangitis	Pseudomonas, (Escherichia coli)	7	Pseudomonas	Bile- duct cul+
66	Liver transplantation	Peritonitis	Stenotropho-monas	4	Stenotropho-monas,	Tracheal swab cul+
77	Hemodialysis	Catheter-related	CoNS ^d	2	CoNS (2×)	Pos. tracheal swab cul+
47	Trauma	Pneumonia	CoNS ^d	2	CoNS, Pseudomonas	Catheter-tip CoNS+
55	Poly-trauma	Abdominal (late detected)	Enterobacter	7	Enterobacter	Enterobacter in cul+
62	Cardiothoracic surgery	Pneumonia; unclear: 2^nd focus	Staph.aureus: MRSA	2	MRSA+ (3×)	Thorax, sternum cul+
58	Artherosklerosis	Pneumonia	Aspergillus	2.5	-	Bronchial aspirate cul+
78	Rectal neo-plasm; perforat-ed abscess	Intra-abdominal	Enterococcus faecium	1.5	Enterococcus faecium (post mortem)	Enterococcus faecalis in drainage cul+
85	Cardiac surgery	Pneumonia	Klebsiella	3	Enterobacter (equivalent the- rapy change )
71	Bypass surgery	Pneumonia	Enterococcus faecalis; (Pseudomonas)	3	Enterococcus faecalis	Pseudomonas in cul+
77	Cardiac surgery	Pneumonia	Klebsiella	5	Klebsiella	Klebsiella in cul+

^a Insufficiently empirically covered PCR+ microorganisms, and (concurrent other PCR+ microorganism).
^b Days gainable on early adequate coverage if the PCR+ information is utilized.
^c Main evidence is the clinical course associated with antimicrobial treatments. In the columns below we report other laboratory findings that suggested drug changes equivalent to those PCR could have triggered earlier (see column #days gainable).
^d in PCR+: above manufacturer cut-off for CoNS.
BC+, blood culture with clinically relevant microorganism identified, not counting contaminations that are immediately at reporting evident to the treating clinician; CoNS, coagulase-negative Staphylococcus; cul+, microorganisms found in cultures of specimen other than positive cultures; MRSA, methicillin-resistant Staphylococcus aureus; PCR, polymerase chain reaction (PCR+: PCR with clinically relevant microorganism identified. Note that in our study, all PCR+ reported microorganisms are considered clinically relevant

ISSN: 1364-8535