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Maubon D, Dard C, Garnaud C, Cornet M. Profile of GenMark's ePlex® blood culture identification fungal pathogen panel. Expert Rev Mol Diagn 2017; 18:119-132. [PMID: 29284316 DOI: 10.1080/14737159.2018.1420476] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Fungemia presents high morbi-mortality and thus rapid microbiological diagnosis may contribute to appropriate patient management. In the last decade, kits based on molecular technologies have become available and health care institutes are increasingly facing critical investment choices. Although all these tools aim to achieve rapid fungal detection and species identification, they display different inherent characteristics. Areas covered: Considering technologies allowing detection and identification of fungal species in a sepsis context, the market proposes either tests on positive blood culture or tests on patient's whole blood. In this review, the authors describe and compare the ePlex® Blood Culture Identification Fungal Pathogen (BCID-FP) test, a fully automated one-step single-use cartridge assay that has been designed to detect identify frequent or rare but emerging, fungal species, from positive blood culture. A comparison with the competing kits is provided. Expert commentaries: The ePlex BCID-FP test provides a diversified and rather relevant panel. Its easy-to-use cartridges allow flexible use around the clock. Nevertheless, prospective clinical studies assessing the time-to-result benefit on antifungal stewardship and on hospital length of stay are not available yet. New tools aim to benefit clinicians and patients, but they should be accompanied by supervision of result interpretation and adaptation of antifungal stewardship.
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Affiliation(s)
- Danièle Maubon
- a Univsité Grenoble Alpes, CNRS, Grenoble INP*, TIMC-IMAG , Grenoble , France.,b Parasitology-Mycology Laboratory, Infectious Agents Department , CHU Grenoble-Alpes , Grenoble , France
| | - Céline Dard
- b Parasitology-Mycology Laboratory, Infectious Agents Department , CHU Grenoble-Alpes , Grenoble , France
| | - Cécile Garnaud
- a Univsité Grenoble Alpes, CNRS, Grenoble INP*, TIMC-IMAG , Grenoble , France.,b Parasitology-Mycology Laboratory, Infectious Agents Department , CHU Grenoble-Alpes , Grenoble , France
| | - Muriel Cornet
- a Univsité Grenoble Alpes, CNRS, Grenoble INP*, TIMC-IMAG , Grenoble , France.,b Parasitology-Mycology Laboratory, Infectious Agents Department , CHU Grenoble-Alpes , Grenoble , France
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Markota A, Sinkovič A. Mortality, intensive care treatment, and cost evaluation: Role of a polymerase chain reaction assay in patients with sepsis. J Int Med Res 2017; 46:79-88. [PMID: 28730906 PMCID: PMC6011302 DOI: 10.1177/0300060517719768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Objective We examined whether patients with a positive SeptiFast (SF) assay (LightCycler SeptiFast; Roche Diagnostics, Basel, Switzerland) developed higher long-term mortality, a more difficult course of treatment, and a higher antimicrobial treatment cost than patients with a negative SF assay. Methods We performed a post-hoc analysis of data collected in a 1-year prospective interventional study of adults with severe sepsis and septic shock. In addition to the standard treatment, an additional 5 ml of blood was obtained for an SF assay, and the antimicrobial treatment was changed according to the SF results. Results We included 57 patients, and the SF assay was positive (SF+) in 10 (17.5%) and negative (SF−) in 47 (82.5%) patients. A trend toward a higher 6-month, 1-year, and 2-year mortality rate was observed in the SF+ group. In the SF+ group, we observed a significantly greater need for second-line vasopressor therapy, a higher initial procalcitonin concentration, and higher maximum C-reactive protein and lactate concentrations. We found no significant differences in cost of antimicrobial treatment between the SF+ and SF− groups. Conclusions We observed a trend toward higher long-term mortality and a more difficult course of treatment but no difference in the cost of antimicrobial treatment.
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Affiliation(s)
- Andrej Markota
- Medical Intensive Care Unit, University Medical Centre Maribor, Ljubljanska 5, Maribor, Slovenia
| | - Andreja Sinkovič
- Medical Intensive Care Unit, University Medical Centre Maribor, Ljubljanska 5, Maribor, Slovenia
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Jordana-Lluch E, Rivaya B, Marcó C, Giménez M, Quesada MD, Escobedo A, Batlle M, Martró E, Ausina V. Molecular diagnosis of bloodstream infections in onco-haematology patients with PCR/ESI-MS technology. J Infect 2016; 74:187-194. [PMID: 27889413 DOI: 10.1016/j.jinf.2016.11.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/05/2016] [Accepted: 11/17/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Onco-haematological patients are prone to develop infections, and antibiotic prophylaxis may lead to negative blood cultures. Thus, the microbiological diagnosis and subsequent administration of a targeted antimicrobial therapy is often difficult. The goal of this study was to evaluate the usefulness of IRIDICA (PCR/ESI-MS technology) for the molecular diagnosis of bloodstream infections in this patient group. METHODS A total of 463 whole blood specimens from different sepsis episodes in 429 patients were analysed using the PCR/ESI-MS platform, comparing the results with those of blood culture and other clinically relevant information. RESULTS The sensitivity of PCR/ESI-MS by specimen (excluding polymicrobial infections, n = 25) in comparison with blood culture was 64.3% overall, 69.0% in oncological patients, and 59.3% in haematological patients. When comparing with a clinical infection criterion, overall sensitivity rose to 74.7%, being higher in oncological patients (80.0%) than in haematological patients (67.7%). Thirty-one microorganisms isolated by culture were not detected by IRIDICA, whereas 42 clinically relevant pathogens not isolated by culture were detected moleculary. CONCLUSIONS PCR/ESI-MS offers a reliable identification of pathogens directly from whole blood. While additional studies are needed to confirm our findings, the system showed a lower sensitivity in onco-haematological patients in comparison with previously reported results in patients from the Intensive Care Unit.
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Affiliation(s)
- Elena Jordana-Lluch
- Microbiology Service, Germans Trias i Pujol University Hospital, Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain; CIBER in Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Belén Rivaya
- Microbiology Service, Germans Trias i Pujol University Hospital, Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain
| | - Clara Marcó
- Microbiology Service, Germans Trias i Pujol University Hospital, Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain
| | - Montserrat Giménez
- Microbiology Service, Germans Trias i Pujol University Hospital, Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain; CIBER in Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Mª Dolores Quesada
- Microbiology Service, Germans Trias i Pujol University Hospital, Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain
| | - Agustín Escobedo
- Oncology Department, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Montserrat Batlle
- Haematology Department, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Elisa Martró
- Microbiology Service, Germans Trias i Pujol University Hospital, Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain; CIBER in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
| | - Vicente Ausina
- Microbiology Service, Germans Trias i Pujol University Hospital, Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain; CIBER in Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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