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Review
. 2018 Oct 10;5(11):ofy257.
doi: 10.1093/ofid/ofy257. eCollection 2018 Nov.

Microbial Identification Using DNA Target Amplification and Sequencing: Clinical Utility and Impact on Patient Management

Tinzar Basein  1 , Bradley J Gardiner  1 , Gabriela M Andujar Vazquez  1 , Andrew S Joel Chandranesan  1 , Arthur R Rabson  2 , Shira Doron  1 , David R Snydman  1   3
Affiliations
Review

Microbial Identification Using DNA Target Amplification and Sequencing: Clinical Utility and Impact on Patient Management

Tinzar Basein et al. Open Forum Infect Dis. .

Abstract

Broad-range polymerase chain reaction (PCR) is increasingly used in patients with culture-negative infections; however, few studies have assessed the diagnostic utility of this test in this context. We performed a retrospective cohort study of patients who had clinical specimens sent for broad-range PCR, aiming to evaluate performance and determine impact on patient management. Organisms were identified in 21/71 samples. High numbers of polymorphonuclear leukocytes on Gram stain (odds ratio [OR], 4.17; P = .04) and acute inflammation on histopathology (OR, 5.69; P = .02) were significantly associated with a positive result. Management was altered in 18 patients, 11 with positive and 7 with negative results. Overall, broad-range PCR assay had the highest impact in patients with microscopic evidence of inflammation. Physicians ordering this complex, difficult to interpret, and expensive test should carefully consider all available clinical information on an individualized basis to optimize its performance.

Keywords: bacterial infection; broad-range PCR; culture negative.

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Figures

Figure 1.
Figure 1.
Diagram demonstrating number and flow of samples/patients included in the study. Abbreviation: PCR, polymerase chain reaction.
See this image and copyright information in PMC

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