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Mediators of Inflammation
Volume 2014, Article ID 108592, 7 pages
http://dx.doi.org/10.1155/2014/108592
Research Article

Diagnostic Utility of Broad Range Bacterial 16S rRNA Gene PCR with Degradation of Human and Free Bacterial DNA in Bloodstream Infection Is More Sensitive Than an In-House Developed PCR without Degradation of Human and Free Bacterial DNA

1Novo Mesto General Hospital, 8000 Novo Mesto, Slovenia
2Institute of Microbiology and Immunology, Faculty of Medicine, 1000 Ljubljana, Slovenia
3Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne 50935, Germany

Received 6 February 2014; Revised 26 May 2014; Accepted 22 June 2014; Published 9 July 2014

Academic Editor: Martin Hoenigl

Copyright © 2014 Petra Rogina et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We compared a commercial broad range 16S rRNA gene PCR assay (SepsiTest) to an in-house developed assay (IHP). We assessed whether CD64 index, a biomarker of bacterial infection, can be used to exclude patients with a low probability of systemic bacterial infection. From January to March 2010, 23 patients with suspected sepsis were enrolled. CD64 index, procalcitonin, and C-reactive protein were measured on admission. Broad range 16S rRNA gene PCR was performed from whole blood (SepsiTest) or blood plasma (IHP) and compared to blood culture results. Blood samples spiked with Staphylococcus aureus were used to assess sensitivity of the molecular assays in vitro. CD64 index was lower in patients where possible sepsis was excluded than in patients with microbiologically confirmed sepsis ( ). SepsiTest identified more relevant pathogens than blood cultures ( ); in three patients (13%) results from blood culture and SepsiTest were congruent, whereas in four cases (17.4%) relevant pathogens were detected by SepsiTest only. In vitro spiking experiments suggested equal sensitivity of SepsiTest and IHP. A diagnostic algorithm using CD64 index as a decision maker to perform SepsiTest shows improved detection of pathogens in patients with suspected blood stream infection and may enable earlier targeted antibiotic therapy.