Abstract
Fast and reliable assays to precisely define the nature of the infectious agents causing sepsis are eagerly anticipated. New molecular biology techniques are now available to define the presence of bacterial or fungal DNA within the bloodstream of sepsis patients. We have used a new technique (VYOO®) that allows the enrichment of microbial DNA before a multiplex polymerase chain reaction (PCR) for pathogen detection provided by SIRS-Lab (Jena, Germany). We analyzed 72 sepsis patients and 14 non-infectious systemic inflammatory response syndrome (SIRS) patients. Among the sepsis patients, 20 had a positive blood culture and 35 had a positive microbiology in other biological samples. Of these, 51.4% were positive using the VYOO® test. Among the sepsis patients with a negative microbiology and the non-infectious SIRS, 29.4% and 14.2% were positive with the VYOO® test, respectively. The concordance in bacterial identification between microbiology and the VYOO® test was 46.2%. This study demonstrates that these new technologies offer great hopes, but improvements are still needed.
Highlights
Sepsis is a common cause of morbidity and death in intensive care units [1,2,3]
Among those systems already commercially available, SeptifastH has been the most studied [29,30,31,32,33,34], results have been inconsistent. We used another available technique for multiplex polymerase chain reaction (PCR) that detects a predefined panel of the most important sepsis pathogens by electrophoretic separation of target-specific amplicons (VYOOH, systemic inflammatory response syndrome (SIRS) lab, Jena, Germany) associated with a specific enrichment of bacterial DNA
We report the first study using this approach in sepsis and non-infectious SIRS patient
Summary
Sepsis is a common cause of morbidity and death in intensive care units [1,2,3]. The diagnosis of sepsis is difficult, because clinical signs of sepsis often overlap with other non-infectious causes of systemic inflammation. SIRS is very common in critically ill patients, being found in various conditions including trauma, surgery, burns, pancreatitis, post-cardiac arrest syndrome, cardiac surgery ( those requiring extracorporeal circulation) and hypoxic injuries [4,5,6]. The search for early biomarker tools for the diagnosis of infection, such as procalcitonin (PCT) and soluble Triggering receptor expressed on myeloid cells-1 (sTREM-1), initially yielded promising results in discriminating sepsis from aseptic SIRS. These results have been widely challenged and are considered controversial because they seem more related to the inflammatory response, irrespective of the cause [14,15]. Up to 40% of the infections remain strongly suspected but not bacteriologically documented [3,16]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
