Moderate positive predictive value of a multiplex real-time PCR on whole blood for pathogen detection in critically ill patients with sepsis

Serological approaches such as Rose Bengal Test (RBT) and enzyme linked immunosorbent assay (ELISA) are common tests, however they are generally not sensitive or specific enough for diagnosis of Brucella because of cross-reactivity with different bacterial antigens. The work objected to evaluate the sensitivity and specificity of rose Bengal and modified in-house ELISA using IS711 real time PCR as a gold test to detect Brucella in calves sera. Two hundred and thirty (n=230) blood samples were collected from (2-3) years asymptomatic male calves in two Egyptian abattoirs. Rose Bengal test (RBT) and modified in-house ELISA were applied to determine the seroprevalence of brucellosis in abattoirs animals while quantitative Taqman real-time PCRs (RT-PCR) were implemented for the identification of Brucella genus. The overall prevalence of brucellosis was (53.9 %), (75.2 %) and (79.1 %) as determined by ELISA,RBT and RT- PCR assays respectively. Regarding statistical analysis of the reported data and considering real time PCR the gold standard, the RBT recorded a sensitivity of (79.12%) and a specificity of (39.58 %) with an accuracy of (70.87%). While (83.24%) was reported as positive predictive value and (33.33 %) as a negative predictive value. The sensitivity and specificity of ELISA were (55.49%) and (52.08 %) respectively while the accuracy was (54.78%). Positive predictive value and negative predictive value for ELISA were determined as (81.45%) and (23.58 %) respectively. RBT can be routinely used for diagnosis of Brucella as cost effective , more sensitive and accurate test than ELISA However, real time PCR is highly recommend as gold test for identification and differentiation of bovine brucellosis.

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Cytomegalovirus infection monitored by quantitative real-time PCR in critically ill patients

Critical Care ◽

10.1186/cc10066 ◽

2011 ◽

Vol 15 (2) ◽

pp. 412 ◽

Cited By ~ 3

Author(s):

Julien Bordes ◽

Tiphaine Gaillard ◽

Jérôme Maslin ◽

Pierre Esnault ◽

Philippe Goutorbe ◽

...

Keyword(s):

Real Time ◽

Critically Ill ◽

Critically Ill Patients ◽

Real Time Pcr ◽

Cytomegalovirus Infection ◽

Quantitative Real Time Pcr

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Model-Based Insulin Sensitivity for Early Diagnosis of Sepsis in Critical Care

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v16i1.1157 ◽

2017 ◽

Vol 16 (1) ◽

Author(s):

Wan Fadzlina Wan Muhd Shukeri ◽

Azrina Md. Ralib ◽

Ummu Khultum Jamaludin ◽

Mohd Basri Mat-Nor

Keyword(s):

Critical Care ◽

Insulin Sensitivity ◽

Glycemic Control ◽

Real Time ◽

Critically Ill ◽

Sensitivity And Specificity ◽

Critically Ill Patients ◽

Predictive Value ◽

Sepsis Group ◽

Model Based

Introduction: Currently, it is almost impossible to diagnose a patient at the onset of sepsis due to the lack of real-time metrics with high sensitivity and specificity. The purpose of the present study is to determine the diagnostic value of model-based insulin sensitivity (SI) as a new sepsis biomarker in critically ill patients, and compare its performance to classical inflammatory parameters. Materials and method: We monitored hourly SI levels in septic (n=19) and non-septic (n=19) critically ill patients in a 24-hour follow-up study. Patients with type I or type II diabetes mellitus were excluded. SI levels were calculated by a validated glycemic control software, STAR TGC (Stochastic TARgeted Tight Glycemic Controller) (Christchurch, NZ). STAR TGC uses a physiological glucose-insulin system model coupled with stochastic models that capture SI variability in real time. Results: The median SI levels were lower in the sepsis group than in the non-sepsis group (1.9 x 10-4 L/mU/min vs 3.7 x 10-4 L/mU/min, P <0.0001). The areas under the receiver operating characteristic curve (AUROC) of the model-based SI for distinguishing non-sepsis from sepsis was 0.911, superior to white cells count (AUROC 0.611) and temperature (AUROC 0.618). The optimal cut-off value of the test was 2.9 x 10-4 L/mU/min. At this cut-off value, the sensitivity and specificity was 88.9% and 84.2%, respectively. The positive predictive value was 84.2%, while the negative predictive value was 88.9%. Conclusion: The early and relevant decrease of SI in sepsis suggests that it might be a promising novel biomarker of sepsis in critical care. Low SI is diagnostic of sepsis, while high SI rules out sepsis, and these may be determined non-invasively in real-time from glycemic control protocol data.

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Immunomodulatory Effect of Continuous Venovenous Hemofiltration during Sepsis: Preliminary Data

BioMed Research International ◽

10.1155/2013/108951 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 12

Author(s):

Giuseppe Servillo ◽

Maria Vargas ◽

Antonio Pastore ◽

Alfredo Procino ◽

Michele Iannuzzi ◽

...

Keyword(s):

Septic Shock ◽

Severe Sepsis ◽

Real Time ◽

Critically Ill ◽

Inflammatory Mediators ◽

Critically Ill Patients ◽

Real Time Pcr ◽

Pcr Analysis ◽

Continuous Venovenous Hemofiltration ◽

Sepsis And Septic Shock

Introduction. Severe sepsis and septic shock are the primary causes of multiple organ dysfunction syndrome (MODS), which is the most frequent cause of death in intensive care unit patients. Many pro- and anti-inflammatory mediators, such as interleukin-6 (IL-6), play a strategic role in septic syndrome. Continuous renal replacement therapy (CRRT) removes in a nonselective way pro- and anti-inflammatory mediators.Objective. To investigate the effects of continuous venovenous hemofiltration (CVVH) as an immunomodulatory treatment of sepsis in a prospective clinical study.Methods. High flux hemofiltration (Qf = 60 ml/Kg/hr) was performed for 72 hr in thirteen critically ill patients suffering from severe sepsis or septic shock with acute renal failure (ARF). IL-6 gene expression was measured by real-time PCR analysis on RNA extracted from peripheral blood mononuclear cell before beginning of treatment (T0) and after 12, 24, 48, and 72 hours (T1–4).Results. Real-time PCR analysis demonstrated in twelve patients IL-6 mRNA reduction after 12 hours of treatment and a progressive increase after 24, 48, and 72 hours.Conclusions. We suggest that an immunomodulatory effect might exist during CVVH performed in critically ill patients with severe sepsis and septic shock. Our data show that the transcriptional activity of IL-6 increases during CVVH.

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P1864 A real-time PCR assay for detection of six common species of Candida from blood, validated in adult critically ill patients

International Journal of Antimicrobial Agents ◽

10.1016/s0924-8579(07)71703-x ◽

2007 ◽

Vol 29 ◽

pp. S534

Author(s):

R. McMullan ◽

L. Metwally ◽

P. Coyle ◽

S. Hedderwick ◽

B. McCloskey ◽

...

Keyword(s):

Real Time ◽

Critically Ill ◽

Critically Ill Patients ◽

Real Time Pcr ◽

Common Species ◽

Pcr Assay

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Validitas Metode Real Time PCR GeneXpert pada Suspek TB Paru BTA Negatif di RSUD Dr. Doris Sylvanus

Jurnal Surya Medika ◽

10.33084/jsm.v7i1.2037 ◽

2021 ◽

Vol 7 (1) ◽

pp. 88-93

Author(s):

Silvani Permatasari ◽

Vani Vrenika ◽

Florence Felicia ◽

Malasinta Malasinta ◽

Ria Eriani ◽

...

Keyword(s):

Positive Predictive Value ◽

Real Time ◽

Negative Predictive Value ◽

Real Time Pcr ◽

Predictive Value ◽

Cross Sectional Study ◽

Sputum Smear ◽

Cross Sectional ◽

Pulmonary Tb ◽

Smear Negative

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Indonesia is one of the developing countries with high TB patients in the world. The most common detection used for TB diagnosis is sputum smear examination. Smear negative pulmonary TB still have a risk of infection and can develop into active. The GeneXpert molecular examination is a rapid diagnosis of TB by the real-time PCR method. The purpose of this study was to assess the validity of GeneXpert in smear-negative pulmonary TB compared to Lowenstein Jensen's culture. The design of this diagnostic test study is a cross-sectional study. The study was conducted on 40 people with smear-negative pulmonary TB suspect patients in Dr. Doris Sylvanus Regional Hospital. Sputum examination was performed with GeneXpert and compared with Lowenstein Jensen culture. The results of GeneXpert validity for diagnosing smear-negative pulmonary TB suspect are sensitivity 81.8%, specificity 96.5%, positive predictive value 90%, negative predictive value 93.3%, and accuracy 92.5%. It was concluded that GeneXpert has sensitivity, specificity, positive predictive value, negative predictive value, and high accuracy as a diagnostic tool in smear-negative pulmonary TB suspects.

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Accuracy of Medical Examiner’s Assessment for Near–Real-Time Surveillance of Fatal Drug Overdoses, King County, Washington, March 2017–February 2018

Public Health Reports ◽

10.1177/00333549211008455 ◽

2021 ◽

pp. 003335492110084

Author(s):

Kirsten Vannice ◽

Julia Hood ◽

Nicole Yarid ◽

Meagan Kay ◽

Richard Harruff ◽

...

Keyword(s):

Public Health ◽

Positive Predictive Value ◽

Real Time ◽

Negative Predictive Value ◽

Drug Overdose ◽

Predictive Value ◽

Death Certificate ◽

King County ◽

Public Health Response ◽

Drug Overdoses

Objectives Up-to-date information on the occurrence of drug overdose is critical to guide public health response. The objective of our study was to evaluate a near–real-time fatal drug overdose surveillance system to improve timeliness of drug overdose monitoring. Methods We analyzed data on deaths in the King County (Washington) Medical Examiner’s Office (KCMEO) jurisdiction that occurred during March 1, 2017–February 28, 2018, and that had routine toxicology test results. Medical examiners (MEs) classified probable drug overdoses on the basis of information obtained through the death investigation and autopsy. We calculated sensitivity, positive predictive value, specificity, and negative predictive value of MEs’ classification by using the final death certificate as the gold standard. Results KCMEO investigated 2480 deaths; 1389 underwent routine toxicology testing, and 361 were toxicologically confirmed drug overdoses from opioid, stimulant, or euphoric drugs. Sensitivity of the probable overdose classification was 83%, positive predictive value was 89%, specificity was 96%, and negative predictive value was 94%. Probable overdoses were classified a median of 1 day after the event, whereas the final death certificate confirming an overdose was received by KCMEO an average of 63 days after the event. Conclusions King County MEs’ probable overdose classification provides a near–real-time indicator of fatal drug overdoses, which can guide rapid local public health responses to the drug overdose epidemic.

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Real‐Time Energy Exposure Is Associated With Increased Oxidative Stress Among Feeding‐Tolerant Critically Ill Patients: Results From the FEDOX Trial

Journal of Parenteral and Enteral Nutrition ◽

10.1002/jpen.1776 ◽

2020 ◽

Vol 44 (8) ◽

pp. 1484-1491 ◽

Cited By ~ 1

Author(s):

Liam McKeever ◽

Sarah J. Peterson ◽

Sofia Cienfuegos ◽

Jaime Rizzie ◽

Omar Lateef ◽

...

Keyword(s):

Oxidative Stress ◽

Real Time ◽

Critically Ill ◽

Critically Ill Patients

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3124 Early Electrographic Seizure Detection by Neuro ICU Nurses via Bedside Real-Time Quantitative EEG

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.93 ◽

2019 ◽

Vol 3 (s1) ◽

pp. 38-38

Author(s):

Safa Kaleem ◽

Christa B. Swisher

Keyword(s):

Positive Predictive Value ◽

Real Time ◽

Predictive Value ◽

Quantitative Eeg ◽

University Hospital ◽

Duke University ◽

Study Population ◽

Time To Detection ◽

Sensitivity Specificity ◽

Improve Patient

OBJECTIVES/SPECIFIC AIMS: 1. Determine positive predictive value, negative predictive value, sensitivity, and specificity of Neuro ICU nurse interpretation of real-time bedside qEEG. 2. Determine difference in time to detection of first seizure between Neuro ICU nurse qEEG interpretation and EEG fellow reads of cEEG. 3. Determine what qualities of seizures make detection by neuro ICU nurses more or less likely – e.g. duration of seizures, type of seizures, spatial extent of seizures. METHODS/STUDY POPULATION: Recruit neuro ICU nurses taking care of 150 patients admitted to the Neuro ICU at Duke University Hospital who are initiated on cEEG monitoring. Nurses will be consented for their participation in the study. Neuro ICU nurses will evaluate the qEE RESULTS/ANTICIPATED RESULTS: From literature estimates of a 20% seizure prevalence in critical care settings, we hope to have 30 patients with seizures and 120 without. Based on prior study in the Duke Neuro ICU, we hypothesize that Neuro ICU nurses will have sensitivity and DISCUSSION/SIGNIFICANCE OF IMPACT: This is the first prospective study of neuro ICU nurse interpretation of real-time bedside qEEG in patients with unknown NCSE/NCS presence. If nurse sensitivity, specificity, and positive predictive value are clinically useful, which we deem would be so at a sensitivity of 70% or greater, with acceptable false alarm rate, nurse readings of qEEG could significantly decrease the time to treatment of seizures in the Neuro ICU patient population, and perhaps could improve patient outcomes.

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