ArticleMedizinische Klinik, Intensivmedizin und Notfallmedizin2012
Microbial diagnostics in patients with presumed severe infection in the emergency department.
Article in Medizinische Klinik, Intensivmedizin und Notfallmedizin, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Accuracy of LightCycler(®) SeptiFast for the detection and identification of pathogens in the blood of patients with suspected sepsis: a systematic review and meta-analysis.Intensive care medicine · 2015Pooled it
- Multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis - a systemic review and meta-analysis.PloS one · 2013Pooled it
- Diagnostic accuracy of SeptiFast multi-pathogen real-time PCR in the setting of suspected healthcare-associated bloodstream infection.Intensive care medicine · 2015Trial
- [Indocyanine green elimination for the evaluation of liver function: prognostic value in patients with community-acquired sepsis].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2014Trial
- Rapid molecular assays versus blood culture for bloodstream infections: a systematic review and meta-analysis.EClinicalMedicine · 2025Article
- Emerging Technologies for Molecular Diagnosis of Sepsis.Clinical microbiology reviews · 2018Review
- Molecular diagnosis of sepsis: New aspects and recent developments.European journal of microbiology & immunology · 2014Article
- Comparison of three different commercial PCR assays for the detection of pathogens in critically ill sepsis patients.Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2013Observational
- APACHE II scoring to predict outcome in post-cardiac arrest.Resuscitation · 2013Article
- Outcome prediction using clinical scores and biomarkers in patients with presumed severe infection in the emergency department.Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2012Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSepsis in the early stage is a common disease in emergency medicine, and rapid diagnosis is essential. Our aim was to compare pathogen diagnosis using blood cultures (BC) and the multiplex polymerase chain reaction (PCR) test.Methods. At total of 211 patients admitted to the multidisciplinary emergency department of our university hospital between 2006 and 2009 with suspected severe infection from any origin were studied. Blood samples for BC (aerobic and anaerobic) and multiplex PCR were taken for identification of infectious microorganisms immediately after hospital admission. Results of the BC and PCR correlated with procalcitonin concentration (PCT) and clinical diagnosis of sepsis (≥2 positive SIRS criteria) as well as with severity of disease at admission and with clinical outcome measures.
resultsResults of the BC were available in 200 patients (94.8%) and PCR were available in 119 patients (56.3%), respectively. In total, 87 BC (43.5%) were positive and identified 94 pathogens. In 45 positive PCRs, 47 pathogens (37.8%) were found. Identical results were obtained in 81.4%. In addition, BC identified 9 Gram-positive and 3 Gram-negative bacteria, while PCR added 5 Gram-negative pathogens. Coagulase-negative staphylococci were detected in blood cultures only (n=20, 21.3%), whereas PCR identified significantly more Gram-negative bacteria than BC. In patients with positive PCR results, the PCT level was significantly higher than in patients with negative PCR (15.0±23.3 vs. 8.8±32.8 ng/ml, p<0.001). This difference was not observed for BC (10.6±25.7 vs. 11.6±44.9 ng/ml, p=0.075). The APACHE II score correlated with PCR (19.2±9.1 vs. 15.8±8.9, p<0.05) and was also higher in positive BC (18.7±8.7 vs. 14.4±8.0, p<0.01). Positive PCR and BC were correlated with negative clinical outcomes (e.g., transfer to ICU, mechanical ventilation, renal replacement therapy, death).
conclusionIn patients admitted with suspected severe infection, a high percentage of positive BC and PCR were observed. Positive findings in the PCR correlate with elevated levels of PCT and high APACHE II scores.
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