Title:
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Rapid Diagnosis of Staphylococcal Catheter-Related Bacteraemia
in Direct Blood Samples by Real-Time PCR
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Author:
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Zboromyrska, Yuliya; Calle, Cristina de la; Soto, Marcelo; Sampietro-Colom, Laura; Soriano Viladomiu, Alex; Álvarez Martínez, Míriam; Almela, M. (Manel); Marco Reverté, Francesc; Arjona, Ruth; Cobos-Trigueros, Nazaret; Morata, Laura; Mensa Pueyo, Josep; Martínez, José Antonio (Martínez Martínez); Mira, Aurea; Vila Estapé, Jordi
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Abstract:
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Catheter-related bacteremia (CRB) is an important cause of
morbidity and mortality among hospitalized patients, being
staphylococci the main etiologic agents. The objective of this
study was to assess the use of a PCR-based assay for detection
of staphylococci directly from blood obtained through the
catheter to diagnose CRB caused by these microorganisms and to
perform a cost-effectiveness analysis. A total of 92 patients
with suspected CRB were included in the study. Samples were
obtained through the catheter. Paired blood cultures were
processed by standard culture methods and 4 ml blood samples
were processed by GeneXpert-MRSA assay for the detection of
methicillin-susceptible (MSSA) or methicillin-resistant (MRSA)
Staphylococcus aureus, and methicillin-resistant
coagulase-negative staphylococci (MR-CoNS). Sixteen CRB caused
by staphylococci were diagnosed among 92 suspected patients.
GeneXpert detected 14 out of 16 cases (87.5%), including 4 MSSA
and 10 MR-CoNS in approximately 1 hour after specimen receipt.
The sensitivity and specificity of GeneXpert were 87.5% (CI 95%:
60.4-97.8) and 92.1% (CI 95%: 83-96.7), respectively, compared
with standard culture methods. The sensitivity of GeneXpert for
S. aureus was 100%. Regarding a cost-effectiveness analysis, the
incremental cost of using GeneXpert was of 31.1euro per patient
while the incremental cost-effectiveness ratio of GeneXpert
compared with blood culture alones was about 180euro per life
year gained. In conclusion, GeneXpert can be used directly with
blood samples obtained through infected catheters to detect S.
aureus and MR-CoNS in approximately 1h after sampling. In
addition, it is cost-effective especially in areas with high
prevalence of staphylococcal CRB. |
Subject(s):
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-Catèters -Infeccions per estafilococs -Reacció en cadena de la polimerasa -Catheters -Staphylococcal infections -Polymerase chain reaction |
Rights:
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cc by (c) Zboromyrska et al., 2016
http://creativecommons.org/licenses/by/3.0/es/ |
Document type:
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Article Article - Published version |
Published by:
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Public Library of Science (PLoS)
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