Molecular diagnosis of microbial aetiologies using SepsiTest™ in the daily routine of a diagnostic laboratory

Diagn Microbiol Infect Dis. 2013 Aug;76(4):413-8. doi: 10.1016/j.diagmicrobio.2013.04.027. Epub 2013 Jun 7.

Abstract

A universal PCR and sequencing test, SepsiTest™ (Molzym, Germany) was evaluated for its applicability during daily diagnostic routine in a privately operated laboratory. In total, 96 specimens originating from 66 patients under suspect of infectious endocarditis, infections of joints, encephalitis/meningitis, systemic infections and infections of unknown genesis were PCR analysed and compared to culture results. Samples comprised cultured and non-cultured blood, synovial fluid, synovial tissue, heart valves, pacemakers, spinal tissue, cerebrospinal fluid, and swabs. PCR and culture were concordant in 26 negative and 8 positive cases (51.5%). A group of 25 patients was culture-negative but PCR-positive (37.9%). In at least 14 of these, common and/or rare aetiologies were identified, while for 4 patients the results of 16S PCR could not be unequivocally linked with the underlying disease. Benefits and limitations of the molecular test are discussed with special emphasis on technical and economic issues. In conclusion, SepsiTest™ proved to be a valuable tool for the diagnosis of aetiologies, particularly in cases of culture-negative patients who are under strong suspicion for an infection.

Keywords: 16S-eubacteria PCR; Endocarditis; Molecular diagnostics; Septicaemia; Universal pathogen detection.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacterial Typing Techniques
  • Candida / classification
  • Candida / genetics
  • Candida / isolation & purification*
  • Culture Media
  • Endocarditis / blood
  • Endocarditis / cerebrospinal fluid
  • Endocarditis / diagnosis*
  • Endocarditis / microbiology
  • Female
  • Gram-Negative Bacteria / classification
  • Gram-Negative Bacteria / genetics
  • Gram-Negative Bacteria / isolation & purification*
  • Gram-Positive Bacteria / classification
  • Gram-Positive Bacteria / genetics
  • Gram-Positive Bacteria / isolation & purification*
  • Heart Valves / microbiology
  • Humans
  • Joints / microbiology
  • Male
  • Middle Aged
  • Mycological Typing Techniques
  • RNA, Ribosomal, 16S / classification
  • RNA, Ribosomal, 16S / genetics*
  • Reagent Kits, Diagnostic*
  • Sensitivity and Specificity
  • Sepsis / blood
  • Sepsis / cerebrospinal fluid
  • Sepsis / diagnosis*
  • Sepsis / microbiology
  • Sequence Analysis, DNA
  • Synovial Fluid / microbiology

Substances

  • Culture Media
  • RNA, Ribosomal, 16S
  • Reagent Kits, Diagnostic