Microbial diagnostics in patients with presumed severe infection in the emergency department.

Medizinische Klinik, Intensivmedizin und Notfallmedizin
S HettwerK Werdan

Abstract

Sepsis in the early stage is a common disease in emergency medicine, and rapid diagnosis is essential. Our aim was to compare pathogen diagnosis using blood cultures (BC) and the multiplex polymerase chain reaction (PCR) test.Methods. At total of 211 patients admitted to the multidisciplinary emergency department of our university hospital between 2006 and 2009 with suspected severe infection from any origin were studied. Blood samples for BC (aerobic and anaerobic) and multiplex PCR were taken for identification of infectious microorganisms immediately after hospital admission. Results of the BC and PCR correlated with procalcitonin concentration (PCT) and clinical diagnosis of sepsis (≥2 positive SIRS criteria) as well as with severity of disease at admission and with clinical outcome measures. Results of the BC were available in 200 patients (94.8%) and PCR were available in 119 patients (56.3%), respectively. In total, 87 BC (43.5%) were positive and identified 94 pathogens. In 45 positive PCRs, 47 pathogens (37.8%) were found. Identical results were obtained in 81.4%. In addition, BC identified 9 Gram-positive and 3 Gram-negative bacteria, while PCR added 5 Gram-negative pathogens. Coagulase-negative staphylococci were det...Continue Reading

Citations

Aug 10, 2012·Medizinische Klinik, Intensivmedizin und Notfallmedizin·J WilhelmK Werdan
Mar 22, 2013·Medizinische Klinik, Intensivmedizin und Notfallmedizin·J SchreiberS Kluge
Sep 3, 2014·Medizinische Klinik, Intensivmedizin und Notfallmedizin·S A KaulenH Ebelt
Mar 29, 2014·European Journal of Microbiology & Immunology·O LiesenfeldG Kost
Nov 28, 2012·Resuscitation·Michael W DonninoMichael N Cocchi
Mar 2, 2018·Clinical Microbiology Reviews·Mridu SinhaStephanie I Fraley

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