JCM Accepts, published online ahead of print on 1 July 2009

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in ASM journals Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by von Lilienfeld-Toal, M. Articles by Stüber, F. Search for Related Content PubMed PubMed Citation Articles by von Lilienfeld-Toal, M. Articles by Stüber, F.

 Previous Article  |  Next Article 

J. Clin. Microbiol. doi:10.1128/JCM.00491-09
Copyright (c) 2009, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Utility of a Commercially Available Multiplex Real-time PCR Assay to Detect Bacterial and Fungal Pathogens in Febrile Neutropenia

Marie von Lilienfeld-Toal^*, Lutz E Lehmann, Ansgar D Raadts, Corinna Hahn-Ast, Katjana S Orlopp, Günter Marklein, Ingvill Purr, Gordon Cook, Andreas Hoeft, Axel Glasmacher, and Frank Stüber

Medizinische Klinik und Poliklinik III, Universitätsklinikum Bonn, Bonn, Germany; Bone Marrow Transplant Unit, St. James's University Hospital, Leeds, UK; Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Bonn, Bonn, Germany; Institut für Medizinische Mikrobiologie, Immunologie und Parasitologie Universitätsklinikum Bonn, Bonn, Germany; Department of Anaesthesiology and Pain Therapy, University Hospital Bern, 3010 Bern, Switzerland

^* To whom correspondence should be addressed. Email: m.lilienfeld.toal{at}uni-bonn.de.

Infection is the main treatment related cause of mortality in cancer patients. Rapid and accurate diagnosis to facilitate specific therapy of febrile neutropenia is therefore urgently warranted. Here, we evaluated a commercial PCR-based Kit to detect the DNA of 20 different pathogens (SeptiFast) in the setting of febrile neutropenia after chemotherapy. Seven hundred and eighty four serum samples of 119 febrile neutropenic episodes (FNE) in 70 patients with hematological malignancies were analyzed and compared with clinical, microbiological and biochemical findings. In the antibiotic-naïve setting, bacteraemia was diagnosed in 34 FNE and 11 of them yielded the same result in the PCR. Seventy-three FNE were negative in both systems, leading to an overall agreement in 84 of 119 FNE (71%). During antibiotic therapy positivity in blood culture occurred only in 3%, but the PCR yielded a positive result in 15%. In 6 cases the PCR during antibiotic treatment detected a new pathogen repetitively, this was accompanied by a significant rise in procalcitonin suggestive of a true detection of infection. All patients with probable invasive fungal infection (IFI, n=3) according to EORTC had a positive PCR result for Aspergillus fumigatus, in contrast there was only one positive result for Aspergillus fumigatus in an episode without signs and symptoms of IFI. Our results demonstrate that the SeptiFast kit cannot replace blood cultures in the diagnostic work-up of FNE. However, it might be helpful in situations when blood cultures remain negative (e.g. during antimicrobial therapy or in IFI).

This article has been cited by other articles:

• Nakamura, A., Sugimoto, Y., Ohishi, K., Sugawara, Y., Fujieda, A., Monma, F., Suzuki, K., Masuya, M., Nakase, K., Matsushima, Y., Wada, H., Katayama, N., Nobori, T. (2010). Diagnostic Value of PCR Analysis of Bacteria and Fungi from Blood in Empiric-Therapy-Resistant Febrile Neutropenia. J. Clin. Microbiol. 48: 2030-2036 [Abstract] [Full Text]  
• Kim, C. M., Song, E. S., Jang, H. J., Kim, H. J., Lee, S., Shin, J. H., Kim, S. J., Jeong, S. H., Jeong, J., Koh, K., Choi, G. E., Lee, E. Y., Chang, C. L. (2010). Development and Evaluation of Oligonucleotide Chip Based on the 16S-23S rRNA Gene Spacer Region for Detection of Pathogenic Microorganisms Associated with Sepsis. J. Clin. Microbiol. 48: 1578-1583 [Abstract] [Full Text]  
• Stevenson, L. G., Drake, S. K., Murray, P. R. (2010). Rapid Identification of Bacteria in Positive Blood Culture Broths by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry. J. Clin. Microbiol. 48: 444-447 [Abstract] [Full Text]  
• Mancini, N., Carletti, S., Ghidoli, N., Cichero, P., Burioni, R., Clementi, M. (2010). The Era of Molecular and Other Non-Culture-Based Methods in Diagnosis of Sepsis. Clin. Microbiol. Rev. 23: 235-251 [Abstract] [Full Text]  
• Tsalik, E. L., Jones, D., Nicholson, B., Waring, L., Liesenfeld, O., Park, L. P., Glickman, S. W., Caram, L. B., Langley, R. J., van Velkinburgh, J. C., Cairns, C. B., Rivers, E. P., Otero, R. M., Kingsmore, S. F., Lalani, T., Fowler, V. G., Woods, C. W. (2010). Multiplex PCR To Diagnose Bloodstream Infections in Patients Admitted from the Emergency Department with Sepsis. J. Clin. Microbiol. 48: 26-33 [Abstract] [Full Text]