Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May 27;4(6):e0707.
doi: 10.1097/CCE.0000000000000707. eCollection 2022 Jun.

Multiple Polymerase Chain Reaction for Direct Detection of Bloodstream Infection After Cardiac Surgery in a PICU

Rosa María Calderón Checa  1 , Manuel Gijón  1 , Sylvia Belda Hofheinz  2 , Pablo Rojo  3
Affiliations

Multiple Polymerase Chain Reaction for Direct Detection of Bloodstream Infection After Cardiac Surgery in a PICU

Rosa María Calderón Checa et al. Crit Care Explor. .

Abstract

Nosocomial infections are a prevalent cause of death and complications in critically ill children. Conventional cultures are able to detect only up to 25% of bacteremia. Several studies have suggested that molecular tests could be a faster and effective tool for detection of bacterial infections. The objective of this study is to compare molecular tests for bacterial detection in whole blood samples, with routine blood culture for the diagnosis of nosocomial bloodstream infections (BSIs).

Design: Prospective cohort study.

Setting: A PICU of a tertiary center, reference for congenital heart diseases.

Patients: Children, 0-16 years, admitted to PICU between August 2016 and December 2019 after cardiac surgery were prospectively recruited. Demographic, clinical, laboratory, and microbiologic data from patient's medical records, and laboratory and microbiologic results were collected.

Interventions: In all patients, blood culture and multiple polymerase chain reaction (PCR) for bacterial detection in a whole blood sample were performed.

Measurements and main results: Fifty-seven cases (patients with suspected infection) and 36 controls (patients with no suspected infection) were recruited during this period; 51.6% were female. Median age was 6 months (interquartile range [IQR], 0-13 mo), and median weight was 5 kg (IQR, 3.5-9.5 kg).From the cases, 33% (19/57) had a confirmed BSI with positive blood culture; 52% were Gram-negative bacilli, and 48% were Gram-positive cocci. Thirty-three percentage (19/57) had a positive PCR with only a 26% (five cases) of concordance between PCR result and blood culture (three bacteremias for Klebsiella pneumoniae, one for Serratia marcescens, and one for Pseudomonas).

Conclusions: Multiple PCRs in whole blood samples did not appear to be more sensitive than blood cultures in this series. Better concordance was found with Gram-negative microorganisms.

Keywords: blood culture; bloodstream infections; cardiac surgery; children; multiple polymerase chain reaction; pediatric intensive care unit.

PubMed Disclaimer

Conflict of interest statement

The authors have disclosed that they do not have any potential conflicts of interest.

References

    1. Elward AM, Fraser VJ: Risk factors for nosocomial primary bloodstream infection in pediatric intensive care unit patients: A 2-year prospective cohort study. Infect Control Hosp Epidemiol 2006; 27:553–560 - PubMed
    1. Abou Elella R, Najm HK, Balkhy H, et al. : Impact of bloodstream infection on the outcome of children undergoing cardiac surgery. Pediatr Cardiol 2010; 31:483–489 - PubMed
    1. Menezes LC, Rocchetti TT, de Castro Bauab K, et al. : Diagnosis by real-time polymerase chain reaction of pathogens and antimicrobial resistance genes in bone marrow transplant patients with bloodstream infections. BMC Infect Dis 2013; 13:166. - PMC - PubMed
    1. Reier-Nilsen T, Farstad T, Nakstad B, et al. : Comparison of broad range 16S rDNA PCR and conventional blood culture for diagnosis of sepsis in the newborn: A case control study. BMC Pediatr 2009; 9:5. - PMC - PubMed
    1. Harris KA, Hartley JC: Development of broad-range 16S rDNA PCR for use in the routine diagnostic clinical microbiology service. J Med Microbiol 2003; 52:685–691 - PubMed