Interdisciplinary Perspectives on Infectious Diseases

Review Article

Clinical Significance of Molecular Diagnostic Tools for Bacterial Bloodstream Infections: A Systematic Review

Table 1

Summary of papers included in this review.
First authorYear of publicationStudy periodStudy countryAge rangeSample sizePatient’s settingType of diagnostic toolDesignCases with bBSIsPerformanceFindings
Faria2015Not statedCanadaAdultNot statedHospital basedIllumina sequencing following PCR amplification of 16S rDNALysis of cells followed by DNA extractionNot statedHigh but not specifiedMolecular profiling is more accurate than blood culture
Jordana-Lluch20142012-2013SpainNot statedNot statedReview type of studyPCR/ESI-MSUse of ampliconsNot statedSensitivity 75%, specificity 92%This molecular technique provides fast diagnosis of clinical samples
Venkatesh [9]2010Not statedUSANeonatalNot statedHospital, ICUMicroarray and PCRDetection of organism by hybridization and amplificationNot statedSensitivity of 98.7%, specificity of 99% for microarray, sensitivity and specificity of 86.4 and 99.0%, respectively, for PCRThese methods are more feasible compared to BC
Warhurst2015Not statedUKNot statedNot statedReview studySeptiFast real-time PCRNot statedNot stated60.8% sensitivity, 86.3% specificityPCR-based assays are more specific but suffer from low sensitivity values
Carrara20134/2011–9/2011SpainNot stated267Hospital, ICUMultiplex PCR assay, the Magicplex Sepsis TestNot stated98Sensitivity 65% (52–76%), specificity 92% (87–95%)Can detect even fastidious bacteria but still needs some improvement to increase sensitivity
Ecker2010Not statedUSABoth adult and childrenNot statedNot statedPCR-ESI/MALDI-TOF/PCR-EIASample extraction, lysis and enrichment with reagentNot statedSensitivity, specificity, and positive and negative predictive values were 95.0, 98.8, 95.0, and 98.8%, respectivelyThey are more accurate, sensitive, and fast compared to blood culture
Boyd20142011–2013CanadaNot stated245Not statedMultiplex PCRUse of 16RNA for bacterial identificationNot statedHigh specificity but low sensitivityThe use of molecular techniques will improve life in septic patients
Lecuit2014Not statedFranceNot statedNot statedReview studyMultiplex PCRBacterial typing is done by detecting conserved 16S rRNA regionsNot stated95% sensitivity, 92% specificityFurther optimization of multiplex PCR is recommended
Reddy [10]2010Not statedTanzania, Malawi, and KenyaAdults and infants221Hospital basedPCRNot stated136ModerateEase of identifying bacterial etiologies
Lehmann2008Not statedGermanyNot stated574Healthy volunteersMultiplex real-time PCRCompare PCR amplicons to the conserved regionsNot statedHigher performance than blood culturePCR-based techniques chosen for their sensitivity and specificity
Wallet2010Not statedFranceNot statedNot statedHospital, ICULightCycler-SeptiFast (LC-SF)Not statedNot statedSensitive at 78%, specific at 99%LC-SF is of valuable interest for patients with sepsis
Bacconi2014Not statedMarylandNot stated331Hospital samplesPCR/EI-MSCells are lysed and followed by DNA extraction by an automated instrument3583% sensitivity, 94% specificityRapid detection and identification of microbes
Tennant2015Not statedPakistan/KarachiAdultNot statedHospital samplesq-PCRNot statedNot stated40% sensitivity, >90% specificityUse of multiple methodologies to increase accuracy
Wang2014Not statedRepublic of KoreaBoth adult and childrenNot statedHospital, ICUThe real-time PCR TaqMan assayDNA extraction from a colony of blood cultureNot satedSensitivity of 100% and specificity of 89.5%Molecular techniques are more specific than BC
Chang20132011–2013USAAdult34Review type of studyLC-SF, multiplex real-time PCRNot stated18High specificity and moderate sensitivityLC-SF multiplex real-time PCR gives more promising results than BC
Liesenfeld2014Not statedUSANot statedNot satedReview type of studyEmphasis on commercially available molecular techniquesNot statedNot statedThe most reported one is the PCR of 84% sensitivity and 94% specificityMolecular methods have advantages in microbial identification, but they must be refined in a good algorithm
Dark2011Not statedUKAdult600Hospital, ICU
Multiplex real-time PCRBC followed by DNA extraction and PCRNot stated95% specific and 87% sensitivePCR-based techniques are better than blood culture when it comes to assay time, sensitivity, and specificity values
Jordana-Lluch20152012–2014SpainNot stated410Hospital basedMultiplex PCRAutomated DNA extraction followed by PCRNot statedSensitivity of 76.9% and specificity of 87.2%A promising technology to detect a wide range of bacterial microbes