Rapid detection and ruling out of neonatal sepsis by PCR coupled with Electrospray Ionization Mass Spectrometry (PCR/ESI-MS)
| Autor: | Cristina Delcò, Oliver Karam, Stéphane Emonet, Riccardo Pfister, Jacques Schrenzel, Alain Gervaix, Klara M. Posfay-Barbe, Gesuele Renzi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Spectrometry Mass Electrospray Ionization medicine.drug_class Electrospray ionization 030106 microbiology Population Antibiotics Gastroenterology Polymerase Chain Reaction Sensitivity and Specificity Sepsis 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Internal medicine medicine Humans Blood culture education Adverse effect Intensive care medicine ddc:616 education.field_of_study ddc:618 medicine.diagnostic_test Neonatal sepsis business.industry Infant Newborn Obstetrics and Gynecology Reproducibility of Results Gold standard (test) medicine.disease Molecular Diagnostic Techniques Pediatrics Perinatology and Child Health Female business |
| Zdroj: | Early Human Development, Vol. 108 (2017) pp. 17-22 |
| ISSN: | 0378-3782 |
| Popis: | Sepsis is an important cause of morbidity and mortality in neonates and clinicians are typically required to administer empiric antibiotics while waiting for blood culture results. However, prolonged and inappropriate use of antibiotics is associated with various complications and adverse events. Better tools to rapidly rule out bacterial infections are therefore needed.We aimed to assess the negative predictive value of PCR coupled with Electrospray Ionization Mass Spectrometry (PCR/ESI-MS) compared to conventional blood cultures in neonatal sepsis.Prospective observational study.All consecutive neonates (28days old) with clinical suspicion of sepsis. Samples for PCR/ESI-MS analysis were collected at the same time as samples for the blood culture, before the initiation of antibiotics.Our primary objective was to evaluate the negative predictive value of PCR/ESI-MS for the detection of bacteria in the bloodstream of newborns with suspected sepsis. Our secondary objective was the evaluation of the sensitivity, specificity and positive predictive value of the PCR/ESI-MS in such a neonatal population.We analysed 114 samples over 14months. The median age and weight were 32weeks+3days and 1840g, respectively. Two patients had negative PCR/ESI-MS results, but positive blood cultures. Overall, the negative predictive value was 98% (95%CI: 92% to 100%).Based on these results, PCR/ESI-MS analysis of blood samples of neonates with suspected sepsis appears to have a very good negative predictive value when compared to blood cultures as gold standard. This novel test might allow for early reassessment of the need for antibiotics. |
| Databáze: | OpenAIRE |
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