Comparison of broad range 16S rDNA PCR and conventional blood culture for diagnosis of sepsis in the newborn: a case control study.

2.50
Hdl Handle:
http://hdl.handle.net/10143/67659
Title:
Comparison of broad range 16S rDNA PCR and conventional blood culture for diagnosis of sepsis in the newborn: a case control study.
Authors:
Reier-Nilsen, Tonje; Farstad, Teresa; Nakstad, Britt; Lauvrak, Vigdis; Steinbakk, Martin
Citation:
Comparison of broad range 16S rDNA PCR and conventional blood culture for diagnosis of sepsis in the newborn: a case control study. BMC Pediatrics 2009, 9:5
Additional Links:
http://www.biomedcentral.com/1471-2431/9/5

Full metadata record

DC FieldValue Language
dc.contributor.authorReier-Nilsen, Tonje-
dc.contributor.authorFarstad, Teresa-
dc.contributor.authorNakstad, Britt-
dc.contributor.authorLauvrak, Vigdis-
dc.contributor.authorSteinbakk, Martin-
dc.date.accessioned2009-05-08T12:20:48Z-
dc.date.available2009-05-08T12:20:48Z-
dc.date.issued2009-01-19-
dc.identifier.citationComparison of broad range 16S rDNA PCR and conventional blood culture for diagnosis of sepsis in the newborn: a case control study. BMC Pediatrics 2009, 9:5en
dc.identifier.issn1471-2431-
dc.identifier.pmid19152691-
dc.identifier.doi10.1186/1471-2431-9-5-
dc.identifier.urihttp://hdl.handle.net/10143/67659-
dc.description.abstractBACKGROUND: Early onset bacterial sepsis is a feared complication of the newborn. A large proportion of infants admitted to the Neonatal Intensive Care Unit (NICU) for suspected sepsis receive treatment with potent systemic antibiotics while a diagnostic workup is in progress. The gold standard for detecting bacterial sepsis is blood culture. However, as pathogens in blood cultures are only detected in approximately 25% of patients, the sensitivity of blood culture is suspected to be low. Therefore, the diagnosis of sepsis is often based on the development of clinical signs, in combination with laboratory tests such as a rise in C-reactive protein (CRP). Molecular assays for the detection of bacterial DNA in the blood represent possible new diagnostic tools for early identification of a bacterial cause. METHODS: A broad range 16S rDNA polymerase chain reaction (PCR) without preincubation was compared to conventional diagnostic work up for clinical sepsis, including BACTEC blood culture, for early determination of bacterial sepsis in the newborn. In addition, the relationship between known risk factors, clinical signs, and laboratory parameters considered in clinical sepsis in the newborn were explored. RESULTS: Forty-eight infants with suspected sepsis were included in this study. Thirty-one patients were diagnosed with sepsis, only 6 of these had a positive blood culture. 16S rDNA PCR analysis of blinded blood samples from the 48 infants revealed 10 samples positive for the presence of bacterial DNA. PCR failed to be positive in 2 samples from blood culture positive infants, and was positive in 1 sample where a diagnosis of a non-septic condition was established. Compared to blood culture the diagnosis of bacterial proven sepsis by PCR revealed a 66.7% sensitivity, 87.5% specificity, 95.4% positive and 75% negative predictive value. PCR combined with blood culture revealed bacteria in 35.1% of the patients diagnosed with sepsis. Irritability and feeding difficulties were the clinical signs most often observed in sepsis. CRP increased in the presence of bacterial infection. CONCLUSION: There is a need for PCR as a method to quickly point out the infants with sepsis. However, uncertainty about a bacterial cause of sepsis was not reduced by the PCR result, reflecting that methodological improvements are required in order for DNA detection to replace or supplement traditional blood culture in diagnosis of bacterial sepsis.en
dc.language.isoenen
dc.relation.urlhttp://www.biomedcentral.com/1471-2431/9/5en
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Pediatri: 760en
dc.subject.meshBacterial Infectionsen
dc.subject.meshC-Reactive Proteinen
dc.subject.meshCase-Control Studiesen
dc.subject.meshDNA, Bacterialen
dc.subject.meshDNA, Ribosomalen
dc.subject.meshEscherichia colien
dc.subject.meshHumansen
dc.subject.meshInfant, Newbornen
dc.subject.meshIntensive Care Units, Neonatalen
dc.subject.meshPolymerase Chain Reactionen
dc.subject.meshRNA, Ribosomal, 16Sen
dc.subject.meshReproducibility of Resultsen
dc.subject.meshSensitivity and Specificityen
dc.subject.meshSepsisen
dc.subject.meshSequence Analysis, DNAen
dc.subject.meshStaphylococcus aureusen
dc.titleComparison of broad range 16S rDNA PCR and conventional blood culture for diagnosis of sepsis in the newborn: a case control study.en
dc.typeJournal articleen
dc.typepeer revieweden
dc.contributor.departmentDepartment of Pediatrics, Akershus University Hospital, Lørenskog, Norway. tonjenil@hotmail.comen
dc.identifier.journalBMC Pediatricsen

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