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The clinical impact of a multiplex real-time PCR system for microbiological diagnosis of sepsis: a mortality study

Abstract:

To evaluate the impact of the use of a multiplex-real time PCR-based assay (SeptiFast M-Grade®) on in-hospital mortality in ICU sepsis patients. Demographic, clinical and microbiological data from ICU patients with suspected sepsis and available SeptiFast (SF) test results were gathered. The intervention group comprised patients in which SF indicated a clinical intervention; the non-intervention group included patients in whom SF result did not lead to any clinical intervention. The study looked at expected and observed in-hospital mortality rates in both intervention and non-intervention groups. Two-hundred and fifty-five patients (121 patients in the intervention group and 134 patients in the non-intervention group) were included in the study. When comparing both groups, we found no significant differences in severity scores, either in estimated or observed mortalities. Older age, high APACHE II scores, and infections caused by Gram-negative pathogens and carbapenem-resistant enterobacteria were all associated with a higher risk of death in both groups. Overall, blood cultures and SF agreed in 75.3% of cases. Positivity rates were 22.0% for blood culture, 29.4% for SF, and 38.0% combined. Though we did not find a correlation between SeptiFast-based intervention and changes in in-hospital mortality, SeptiFast improved positivity rates. The above improvement in microbiological diagnosis might be associated with fewer complications, lower hospitalization costs and presumably better long-term survival rates in sepsis patients.