Performance of real-time PCR in suspected haemodialysis catheter-related bloodstream infection: a proof-of-concept study. - Biology of Cardiovascular Diseases Accéder directement au contenu
Article Dans Une Revue Clinical Kidney Journal Année : 2023

Performance of real-time PCR in suspected haemodialysis catheter-related bloodstream infection: a proof-of-concept study.

Résumé

Catheter-related bloodstream infections (CRBIs) remain a major cause of mortality in haemodialysis (HD) patients with central venous catheters (CVCs), especially because of the non-specific symptomatology and the delay in microbiological diagnosis with possible use of non-optimal empiric antibiotics. Moreover, empiric broad-spectrum antibiotics increase antibiotic resistance development. This study aims to evaluate the diagnostic performance of real-time polymerase chain reaction (rt-PCR) in suspected HD CRBIs compared with blood cultures. A blood sample for rt-PCR was collected simultaneously with each pair of blood cultures for suspected HD CRBI. The rt-PCR was performed on the whole blood, without any enrichment stage and with specific DNA primers: 16S (universal bacterial), spp., and . Each successive patient with a suspected HD CRBI in the HD centre of Bordeaux University Hospital was included. Performance tests were used to compare the result obtained in each rt-PCR assay with its corresponding routine blood culture. Eighty-four paired samples were collected and compared for 40 suspected HD CRBI events in 37 patients. Among these, 13 (32.5%) were diagnosed as HD CRBI. All rt-PCRs except (insufficient number of positive samples) showed high diagnostic performances within 3.5 h: 16S (sensitivity 100%, specificity 78%), spp. (sensitivity 100%, specificity 97%), (sensitivity 100%, specificity 99%). Based on the rt-PCR results, antibiotics could be more appropriately targeted, thus cutting anti-cocci Gram-positive therapy from 77% to 29%. The performance of rt-PCR in suspected HD CRBI events showed fast and high diagnostic accuracy. Its use would improve HD CRBI management with an antibiotic consumption decrease.
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hal-04095065 , version 1 (11-05-2023)

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  • HAL Id : hal-04095065 , version 1

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Mathieu Acquier, Arnaud Zabala, Valérie de Précigout, Yahsou Delmas, Véronique Dubois, et al.. Performance of real-time PCR in suspected haemodialysis catheter-related bloodstream infection: a proof-of-concept study.. Clinical Kidney Journal, 2023, 16 (3), pp.494-500. ⟨hal-04095065⟩
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