RADICAL study: rapid diagnosis of suspected bloodstream infections from direct blood testing using PCR/ESI-MS

D Brealey,M O'Dwyer,J-L Vincent,K Zacharowski,M Singer,Dj Ecker,M Mikaszewska-Sokolewicz,R Sampath,Mp Maureau,J Pugin,N Libert

doi:10.1186/cc14064

Abstract

Survival from sepsis and bloodstream infections (BSI) often depends upon rapid identification of the infecting pathogen and expeditious antimicrobial therapy. We report findings from the final analysis of RADICAL, a multicenter observational study that compared results from direct blood specimen testing using PCR/ESI-MS to standard microbiology in critically ill patients.

Highlights

During the course of systemic inflammation, most of the immune cell types get activated to a certain degree as part of, or contributing to, the cascade of physiopathological events
This study aimed to find out whether mean differences of 6-hour, 12-hour, and 24-hour lactate clearance were observed between nonsurvivors and survivors of acute phase mortality in severe sepsis and septic shock patients
After the development of sepsis we detected in all patients significantly increased heart rate, respiratory rate per minute, leukocytosis, anemia, worse glucose metabolism and renal function (Table 1)

Summary

Introduction

During the course of systemic inflammation, most of the immune cell types get activated to a certain degree as part of, or contributing to, the cascade of physiopathological events. This study was aimed to address the association of achieving either one or two targets of microcirculatory end point resuscitation and early mortality in severe sepsis and septic shock patients. A leading cause of death in critical care patients, is the result of complex interactions between the infecting microorganisms and the host responses that influence clinical outcomes [1]. We previously demonstrated that pentyleneterazol (PTZ)-induced generalized epileptic seizures significantly increased inflammatory markers (TNFa, IL-1b, IL-6) in the brain and S100B in serum [4] In this preliminary study, we aimed to investigate the MMP2, MMP9, NOS, and myeloperoxidase activity in the liver and kidney and levels of serum proinflammatory cytokines following. We aimed to evaluate the correlation between septicemia and high-density lipoprotein (HDL) level in burned patients

Objectives

Methods

Results

Conclusion