Molecular diagnosis of sepsis in neutropenic patients with haematological malignancies

Nicasio Mancini, Daniela Clerici, Roberta Diottï, Mario Perotti, Nadia Ghidoli, Donata De Marco, Beatrice Pizzorno, Thomas Emrich, Roberto Burioni, Fabio Ciceri, Massimo Clementi

Research output: Contribution to journalArticle

116 Citations (Scopus)

Abstract

The rapid diagnosis of an infectious cause in the course of fever of unknown origin plays a pivotal role in the correct management of neutropenic patients. In this study, blood samples from febrile oncohaematological patients were tested using a novel commercial real-time PCR assay (LightCycler SeptiFast; Roche Molecular Systems) and blood culture (BacT/Alert 3D; bioMérieux). Twenty-one (20.4%) and 34 (33%) of the 103 samples under study tested positive by blood culture and PCR, respectively. The analysis of concordance evidenced a low correlation between the two approaches (83 %), mainly due to samples that tested negative by culture but positive using the molecular approach. Among 14 discordant cases negative by culture but positive by PCR, 12 were observed in sequential samples of patients with initial concordant results on samples drawn before the administration of a specific antimicrobial therapy. Moreover, DNA of a fastidious organism, Aspergillus fumigatus, not easily detectable by the cultural approach was rapidly detected in the two remaining discordant cases. Overall, the characteristics featured by the molecular method could be of interest in the development of new algorithms for the diagnosis of sepsis in critical patients.

Original languageEnglish
Pages (from-to)601-604
Number of pages4
JournalJournal of Medical Microbiology
Volume57
Issue number5
DOIs
Publication statusPublished - May 2008

Fingerprint

Hematologic Neoplasms
Sepsis
Fever of Unknown Origin
Polymerase Chain Reaction
Aspergillus fumigatus
Real-Time Polymerase Chain Reaction
Fever
DNA
Blood Culture
Therapeutics

ASJC Scopus subject areas

  • Microbiology (medical)
  • Microbiology

Cite this

Molecular diagnosis of sepsis in neutropenic patients with haematological malignancies. / Mancini, Nicasio; Clerici, Daniela; Diottï, Roberta; Perotti, Mario; Ghidoli, Nadia; De Marco, Donata; Pizzorno, Beatrice; Emrich, Thomas; Burioni, Roberto; Ciceri, Fabio; Clementi, Massimo.

In: Journal of Medical Microbiology, Vol. 57, No. 5, 05.2008, p. 601-604.

Research output: Contribution to journalArticle

Mancini, Nicasio ; Clerici, Daniela ; Diottï, Roberta ; Perotti, Mario ; Ghidoli, Nadia ; De Marco, Donata ; Pizzorno, Beatrice ; Emrich, Thomas ; Burioni, Roberto ; Ciceri, Fabio ; Clementi, Massimo. / Molecular diagnosis of sepsis in neutropenic patients with haematological malignancies. In: Journal of Medical Microbiology. 2008 ; Vol. 57, No. 5. pp. 601-604.
@article{051a97aac27c464485482241d8e86653,
title = "Molecular diagnosis of sepsis in neutropenic patients with haematological malignancies",
abstract = "The rapid diagnosis of an infectious cause in the course of fever of unknown origin plays a pivotal role in the correct management of neutropenic patients. In this study, blood samples from febrile oncohaematological patients were tested using a novel commercial real-time PCR assay (LightCycler SeptiFast; Roche Molecular Systems) and blood culture (BacT/Alert 3D; bioM{\'e}rieux). Twenty-one (20.4{\%}) and 34 (33{\%}) of the 103 samples under study tested positive by blood culture and PCR, respectively. The analysis of concordance evidenced a low correlation between the two approaches (83 {\%}), mainly due to samples that tested negative by culture but positive using the molecular approach. Among 14 discordant cases negative by culture but positive by PCR, 12 were observed in sequential samples of patients with initial concordant results on samples drawn before the administration of a specific antimicrobial therapy. Moreover, DNA of a fastidious organism, Aspergillus fumigatus, not easily detectable by the cultural approach was rapidly detected in the two remaining discordant cases. Overall, the characteristics featured by the molecular method could be of interest in the development of new algorithms for the diagnosis of sepsis in critical patients.",
author = "Nicasio Mancini and Daniela Clerici and Roberta Diott{\"i} and Mario Perotti and Nadia Ghidoli and {De Marco}, Donata and Beatrice Pizzorno and Thomas Emrich and Roberto Burioni and Fabio Ciceri and Massimo Clementi",
year = "2008",
month = "5",
doi = "10.1099/jmm.0.47732-0",
language = "English",
volume = "57",
pages = "601--604",
journal = "Journal of Medical Microbiology",
issn = "0022-2615",
publisher = "Society for General Microbiology",
number = "5",

}

TY - JOUR

T1 - Molecular diagnosis of sepsis in neutropenic patients with haematological malignancies

AU - Mancini, Nicasio

AU - Clerici, Daniela

AU - Diottï, Roberta

AU - Perotti, Mario

AU - Ghidoli, Nadia

AU - De Marco, Donata

AU - Pizzorno, Beatrice

AU - Emrich, Thomas

AU - Burioni, Roberto

AU - Ciceri, Fabio

AU - Clementi, Massimo

PY - 2008/5

Y1 - 2008/5

N2 - The rapid diagnosis of an infectious cause in the course of fever of unknown origin plays a pivotal role in the correct management of neutropenic patients. In this study, blood samples from febrile oncohaematological patients were tested using a novel commercial real-time PCR assay (LightCycler SeptiFast; Roche Molecular Systems) and blood culture (BacT/Alert 3D; bioMérieux). Twenty-one (20.4%) and 34 (33%) of the 103 samples under study tested positive by blood culture and PCR, respectively. The analysis of concordance evidenced a low correlation between the two approaches (83 %), mainly due to samples that tested negative by culture but positive using the molecular approach. Among 14 discordant cases negative by culture but positive by PCR, 12 were observed in sequential samples of patients with initial concordant results on samples drawn before the administration of a specific antimicrobial therapy. Moreover, DNA of a fastidious organism, Aspergillus fumigatus, not easily detectable by the cultural approach was rapidly detected in the two remaining discordant cases. Overall, the characteristics featured by the molecular method could be of interest in the development of new algorithms for the diagnosis of sepsis in critical patients.

AB - The rapid diagnosis of an infectious cause in the course of fever of unknown origin plays a pivotal role in the correct management of neutropenic patients. In this study, blood samples from febrile oncohaematological patients were tested using a novel commercial real-time PCR assay (LightCycler SeptiFast; Roche Molecular Systems) and blood culture (BacT/Alert 3D; bioMérieux). Twenty-one (20.4%) and 34 (33%) of the 103 samples under study tested positive by blood culture and PCR, respectively. The analysis of concordance evidenced a low correlation between the two approaches (83 %), mainly due to samples that tested negative by culture but positive using the molecular approach. Among 14 discordant cases negative by culture but positive by PCR, 12 were observed in sequential samples of patients with initial concordant results on samples drawn before the administration of a specific antimicrobial therapy. Moreover, DNA of a fastidious organism, Aspergillus fumigatus, not easily detectable by the cultural approach was rapidly detected in the two remaining discordant cases. Overall, the characteristics featured by the molecular method could be of interest in the development of new algorithms for the diagnosis of sepsis in critical patients.

UR - http://www.scopus.com/inward/record.url?scp=43049121061&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=43049121061&partnerID=8YFLogxK

U2 - 10.1099/jmm.0.47732-0

DO - 10.1099/jmm.0.47732-0

M3 - Article

C2 - 18436593

AN - SCOPUS:43049121061

VL - 57

SP - 601

EP - 604

JO - Journal of Medical Microbiology

JF - Journal of Medical Microbiology

SN - 0022-2615

IS - 5

ER -