Clinical impact of a multiplex real-time PCR assay (SeptiFast®) for the rapid detection of pathogens in patients with end-stage heart failure bridged to heart transplantation with ventricular assist devices

A Chaidaroglou,P Alivizatos,P Sfyrakis,A Gouziouta,E Manoli,P Gourzi,D Degiannis,M Pantou,G Saroglou

doi:10.1186/cc9133

Abstract

Implantable ventricular assist devices (VADs) are widely used in patients with end-stage heart failure as a bridge to heart transplantation (HTx) or as destination therapy (DT); however, their use is associated with increased postoperative infection-related morbidity and mortality. Rapid identification of responsible organisms is imperative for the initiation of appropriate treatment and for lowering mortality due to sepsis. Direct detection of pathogens in blood samples by nucleic acid amplification is a sensitive and fast alternative to blood cultures. The multiplex real-time PCR system SeptiFast® (Roche Diagnostics) allows for rapid detection and identification of the 25 most common pathogens (Gram-positive and Gram-negative bacteria and fungi) in blood, in less than 6 hours. The aim of this study was to evaluate the usefulness of SeptiFast® in patients with implanted VADs.

Highlights

In 2002, the Surviving Sepsis Campaign defined a strategy that aimed to reduce the high mortality due to sepsis
Endogenous respiration of intact platelets suspended in their own plasma or PBS glucose was determined and, in order to investigate the activity of individual complexes of the respiratory system, platelets were permeabilized with digitonin and stimulated with complex-specific substrates and inhibitors
For example at 5 μg/ml LPS, the expression of GIPR was reduced to 86% and INSR 72% of control in U937: while in HUH7 cells at 1 μg/ml LPS, the GIPR expression was decreased to 63%, GLP-1R 95% and INSR 89% compared with control (P

Summary

Introduction

In 2002, the Surviving Sepsis Campaign defined a strategy that aimed to reduce the high mortality due to sepsis. Patients admitted to ICUs with severe sepsis have a 39.8% risk of death [2], and for each hour delay in antibiotic administration, a 7.6% increase in mortality [3]. The objective of the present study was to evaluate the impact of early fluid resuscitation on serial TNFα and IL-6 levels and its association with mortality in severe sepsis. Our laboratory has demonstrated in preliminary clinical studies among the various biomarkers of endothelial dysfunction that blood levels of endocan (ESM-1), a pulmonary vascular endothelial cell-specific molecule participating in the control of endothelial–leukocyte interactions, are associated with the severity and evolution of septic states. The objective, of our study was to predict the development of organ failure at 24 hours using only the data available from the first 4 hours post inoculation Methods This pneumonia-sepsis model included 19 sheep with ALI. The sera were analyzed through serological (IgM and IgG specific ELISA) and molecular (gel-based and real-time RT-PCR) testing

Methods

Results

Conclusion