Skip to main content

Advertisement

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

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

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: 2nd 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+
  1. a Insufficiently empirically covered PCR+ microorganisms, and (concurrent other PCR+ microorganism).
  2. b Days gainable on early adequate coverage if the PCR+ information is utilized.
  3. 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).
  4. d in PCR+: above manufacturer cut-off for CoNS.
  5. 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