Detection of fungemia by polymerase chain reaction in critically ill neonates and children

Abstract

Objective: To compare polymerase chain reaction (PCR) with blood culture for the detection of fungemia in neonatal and pediatric intensive care unit patients.

Study design: A total of 0.2 to 0.5 ml of blood was collected simultaneously with blood culture in patients with suspected sepsis. Following DNA extraction, the gene for fungal 18S rRNA was amplified and PCR products analyzed by agarose gel electrophoresis.

Results: Of 70 patient samples, nine of nine with a positive blood culture for Candida were PCR positive, and one of four with a positive blood culture for Malassezia was PCR positive. In total, 13 of 57 samples with negative blood culture for fungus were PCR positive. Seven of these 13 patients had other evidence of invasive fungal disease. In contrast, none of the 44 blood culture-negative/PCR-negative patients had other evidence of fungal infection.

Conclusions: PCR may be a useful adjunct to blood culture for the rapid detection of fungemia in high-risk patients.