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Journal of Clinical Microbiology, July 2000, p. 2574-2578, Vol. 38, No. 7
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Comparison of 16S rRNA Gene PCR and BACTEC 9240 for Detection of Neonatal Bacteremia

J. A. Jordan1,2,* and M. B. Durso1

Magee-Women's Research Institute1 and Department of Pathology, University of Pittsburgh,2 Pittsburgh, Pennsylvania 15213

Received 30 December 1999/Returned for modification 10 February 2000/Accepted 10 May 2000

Ten percent of infants born in the United States are admitted to neonatal intensive care units (NICU) annually. Approximately one-half of these admissions are from term infants (>34 weeks of gestation) at risk for systemic infection. Most of the term infants are not infected but rather have symptoms consistent with other medical conditions that mimic sepsis. The current standard of care for evaluating bacterial sepsis in the newborn is performing blood culturing and providing antibiotic therapy while awaiting the 48-h preliminary result of culture. Implementing a more rapid means of ruling out sepsis in term newborns could result in shorter NICU stays and less antibiotic usage. The purpose of this feasibility study was to compare the utility of PCR to that of conventional culture. To this end, a total of 548 paired blood samples collected from infants admitted to the NICU for suspected sepsis were analyzed for bacterial growth using the BACTEC 9240 instrument and for the bacterial 16S rRNA gene using a PCR assay which included a 5-h preamplification culturing step. The positivity rates by culture and PCR were 25 (4.6%) and 27 (4.9%) positive specimens out of a total of 548 specimens, respectively. The comparison revealed sensitivity, specificity, and positive and negative predictive values of 96.0, 99.4, 88.9, and 99.8%, respectively, for PCR. In summary, this PCR-based approach, requiring as little as 9 h of turnaround time and blood volumes as small as 200 µl, correlated well with conventional blood culture results obtained for neonates suspected of having bacterial sepsis.

* Corresponding author. Mailing address: Magee-Women's Research Institute, 204 Craft Ave., Laboratory 440, Pittsburgh, PA 15213. Phone: (412) 641-4104. Fax: (412) 641-6156. E-mail: jordanja+{at}pitt.edu.

Journal of Clinical Microbiology, July 2000, p. 2574-2578, Vol. 38, No. 7
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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