Open AccessEvaluation of the Septifast MGrade Test on Standard Care Wards—A Cohort Study
Author(s) -
Franz Ratzinger,
Irene Tsirkinidou,
Helmuth Haslacher,
Thomas Perkmann,
Klaus G. Schmetterer,
Dieter Mitteregger,
Athanasios Makristathis,
Heinz Burgmann
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0151108
Subject(s) - medicine , bacteremia , sepsis , systemic inflammatory response syndrome , incidence (geometry) , confidence interval , blood culture , prospective cohort study , blood test , cohort , gastroenterology , antibiotics , microbiology and biotechnology , physics , optics , biology
Background The immediate need for appropriate antimicrobial therapy in septic patients requires the detection of the causative pathogen in a timely and reliable manner. In this study, the real-time PCR Septifast M Grade test was evaluated in adult patients meeting the systemic inflammatory response syndrome (SIRS) criteria that were treated at standard care wards. Methods Patients with clinical suspected infection, drawn blood cultures (BC), the Septifast M Grade test (SF) and sepsis biomarkers were prospectively screened for fulfillment of SIRS criteria and evaluated using the criteria of the European Centre of Disease Control (ECDC) for infection point prevalence studies. Results In total, 220 patients with SIRS were prospectively enrolled, including 56 patients with detection of bacteria in the blood (incidence: 25.5%). BC analysis resulted in 75.0% sensitivity (95% confidence interval, CI: 61.6%– 85.6%) with 97.6% specificity (CI: 93.9%– 99.3%) for detecting bacteria in the blood. In comparison to BC, SF presented with 80.4% sensitivity (CI: 67.6%– 89.8%) and with 97.6% specificity (CI: 93.9%– 99.3%). BC and SF analysis yielded comparable ROC-AUCs (0.86, 0.89), which did not differ significantly (p = 0.558). A trend of a shorter time-to-positivity of BC analysis was not seen in bacteremic patients with a positive SF test than those with a negative test result. Sepsis biomarkers, including PCT, IL-6 or CRP, did not help to explain discordant test results for BC and SF. Conclusion Since negative results do not exclude bacteremia, the Septifast M Grade test is not suited to replacing BC, but it is a valuable tool with which to complement BC for faster detection of pathogens.