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J Med Microbiol 57 (2008), 601-604; DOI: 10.1099/jmm.0.47732-0
© 2008 Society for General Microbiology
ISSN 1473-5644

Molecular diagnosis of sepsis in neutropenic patients with haematological malignancies

Nicasio Mancini1, Daniela Clerici2, Roberta Diotti1, Mario Perotti1, Nadia Ghidoli1, Donata De Marco1, Beatrice Pizzorno3, Thomas Emrich4, Roberto Burioni1, Fabio Ciceri2 and Massimo Clementi1

1 Laboratorio di Microbiologia e Virologia, Università ‘Vita-Salute’ San Raffaele, Milano, Italy

2 Unità di Ematologia e Trapianto di Midollo Osseo, Istituto Scientifico San Raffaele, Milano, Italy

3 Roche Diagnostics S.p.A., Monza, Italy

4 Roche Diagnostics GmbH, Molecular Diagnostics, Penzberg, Germany

Correspondence
Nicasio Mancini
mancini.nicasio{at}hsr.it

Received 29 October 2007
Accepted 28 January 2008

The rapid diagnosis of an infectious cause in the course of fever of unknown origin plays a pivotal role in the correct management of neutropenic patients. In this study, blood samples from febrile oncohaematological patients were tested using a novel commercial real-time PCR assay (LightCycler SeptiFast; Roche Molecular Systems) and blood culture (BacT/Alert 3D; bioMérieux). Twenty-one (20.4 %) and 34 (33 %) of the 103 samples under study tested positive by blood culture and PCR, respectively. The analysis of concordance evidenced a low correlation between the two approaches (83 %), mainly due to samples that tested negative by culture but positive using the molecular approach. Among 14 discordant cases negative by culture but positive by PCR, 12 were observed in sequential samples of patients with initial concordant results on samples drawn before the administration of a specific antimicrobial therapy. Moreover, DNA of a fastidious organism, Aspergillus fumigatus, not easily detectable by the cultural approach was rapidly detected in the two remaining discordant cases. Overall, the characteristics featured by the molecular method could be of interest in the development of new algorithms for the diagnosis of sepsis in critical patients.




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