A prediction model for real-time PCR results in blood samples from febrile patients with suspected sepsis
| Autor: | Christian Leli, Carla Ferri, Antonella Mencacci, Francesco D'Alò, Angela Cardaccia, Francesco Bistoni |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Microbiology (medical)
Male medicine.medical_specialty Molecular Diagnostic Techniques Real-Time Polymerase Chain Reaction Sepsis Serum albumin Microbiology Gastroenterology Sensitivity and Specificity Procalcitonin Specimen Handling Internal medicine medicine Humans Retrospective Studies Aged 80 and over biology business.industry Organ dysfunction General Medicine Odds ratio Middle Aged medicine.disease Confidence interval Surgery Real-time polymerase chain reaction ROC Curve biology.protein Female medicine.symptom business Blood sampling |
| Popis: | Sepsis, a systemic, deleterious host response to infection that leads to organ dysfunction, is a potentially deadly condition needing prompt identification of the causative organisms and early appropriate antimicrobial therapy. Among non-culture-based diagnostic methods, SeptiFast (SF) can be employed to speed bacterial and fungal DNA detection, but it suffers from poor sensitivity and high cost. The aim of the present study, performed in 285 febrile patients, was to develop a prediction model to restrict the SF assay to clinical cases with a high probability of positive SF results. The prevalence of SF results positive for a pathogen was 17.2 %. Independent predictors of positive results were: blood sampling within 12 h after the onset of fever [odds ratio (OR) 20.03; 95 % confidence interval (CI) 6.87–58.38; P−1 (OR 18.52; 95 % CI 5.12–67.02; PP = 0.009); ≤3 g serum albumin dl−1 (OR 3.40; 95 % CI 1.27–9.08; P = 0.014); and ≥13 000 white blood cells mm−3 (OR 2.75; 95 % CI 1.09–7.69; P = 0.05). The model showed good calibration (Hosmer–Lemeshow chi-squared 1.61; P = 0.978). Area under the receiving operating characteristic curve was 0.944 (95 % CI 0.914–0.973; P |
| Databáze: | OpenAIRE |
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