Optimització del diagnòstic microbiològic de la bacterièmia en un hospital sense atenció continuada. Aplicació d’una PCR Multiplex sobre frasc d’hemocultiu

Abstract

The microbiological diagnosis of bacteremia is essential to an early establishment of the approppriate treatment. We present a study of 133 patients performing multiplex PCR (FA-BCID) in parallel with conventional blood culture. The diagnosis was advanced by about two days on positive blood culture. The concordance was 79%, 95% CI (66.86), due to the detection of S.pneumoniae which was not isolated. In 22% of patients, the ATB was modified when the PCR result was known. The percentage of polymorphonuclear cells and the age are the only relevant parameters in order to condition a positive PCR result. Experimental PCR was performed in non-positivized blood cultures. In six cases the identification could be considerably advanced. The concordance when PCR was negative with the culture was 82.3%. Especially in hospitals without continuous care, FA-BCID is a good tool that can speed up the diagnosis but cannot replace traditional blood culture.