TY - JOUR AU - Schaub, Nora AU - Boldanova, Tujana AU - Noveanu, Markus AU - Arenja, Nisha AU - Hermann, Heinz AU - Twerenbold, Raphael AU - Frei, Reno AU - Bingisser, Roland AU - Trampuz, Andrej AU - Müller, Christian PY - 2014/01/26 Y2 - 2024/03/28 TI - Incremental value of multiplex real-time PCR for the early diagnosis of sepsis in the emergency department JF - Swiss Medical Weekly JA - Swiss Med Wkly VL - 144 IS - 0506 SE - Original article DO - 10.4414/smw.2014.13911 UR - https://smw.ch/index.php/smw/article/view/1818 SP - w13911 AB - <p><p>BACKGROUND: Delayed recognition of sepsis and inappropriate initial antibiotic therapy are associated with increased mortality and morbidity. The early detection of the causative organism in sepsis is an unmet clinical need. A novel multiplex real-time polymerase chain reaction (MRT-PCR) (Septi<em>Fast</em>®) technique may provide the microbiological diagnosis within six hours.</p> <p>METHODS: We assessed the diagnostic accuracy of blood cultures and MRT-PCR in a comparative diagnostic cohort study in 110 consecutive adult patients presenting to the emergency department (ED) with suspected sepsis.</p> <p>RESULTS: We collected 205 corresponding PCR samples and blood culture (BC) pairs from the 110 patients. There was moderate to high concordance between PCR and BC with 181 (88%) matching and 24 (12%) mismatching samples. The diagnostic accuracy of MRT-PCR in detecting sepsis and its causative organism was comparable to that of BCs. The additional use of MRT-PCR significantly reduced the time to microbiological diagnosis as compared to the use of conventional microbiological methods alone (mean time gained 3.9 hours, range 0–66 hours, p &lt;0.001).</p> <p>CONCLUSION: Diagnostic accuracy of BCs and MRT-PCR in the early diagnosis of sepsis and its causative organism in the ED are comparable. However, MRT-PCR reduces the time to microbiological diagnosis. Whether a more rapid detection of the organism by MRT-PCR could improve the outcome of patients has to be assessed in large prospective randomised trials.</p></p> ER -