Evaluation of broad-range 16S rRNA PCR for the diagnosis of bloodstream infections: two years of experience

Introduction: Diagnosis of bloodstream infections using bacteriological cultures suffers from low sensitivity and reporting delay. Advanced molecular techniques introduced in many laboratories provide rapid results and may show improvements in patient outcomes. This study aimed to evaluate the usefulness of a molecular technique, broad-range 16S rRNA PCR followed by sequencing for the diagnosis of bloodstream infections, compared to blood culture in different patient groups. Methodology: Conventional PCR was performed, using broad-range 16S rRNA primers, on blood cultures collected from different patients with suspected bloodstream infections; results were compared with those of blood culture. Results: Though blood culture is regarded as the gold standard, PCR evaluation showed sensitivity of 86.25%, specificity of 91.25%, positive predictive value of 76.67%, negative predictive value of 95.22%, and accuracy of 88.8%. Conclusions: Molecular assays seem not to be sufficient to replace microbial cultures in the diagnosis of bloodstream infections, but they can offer a rapid, good negative test to rule out infection due to their high negative predictive value.

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Clinical Factors Associated with Atrial Fibrillation Detection on Single-Time Point Screening Using a Hand-Held Single-Lead ECG Device

Journal of Clinical Medicine ◽

10.3390/jcm10040729 ◽

2021 ◽

Vol 10 (4) ◽

pp. 729 ◽

Cited By ~ 1

Author(s):

Giuseppe Boriani ◽

Pietro Palmisano ◽

Vincenzo Livio Malavasi ◽

Elisa Fantecchi ◽

Marco Vitolo ◽

...

Keyword(s):

Atrial Fibrillation ◽

Negative Predictive Value ◽

Predictive Value ◽

High Sensitivity ◽

Lower Sensitivity ◽

Single Time ◽

High Negative Predictive Value ◽

Low Sensitivity ◽

Single Time Point ◽

Time Point

Our aim was to assess the prevalence of unknown atrial fibrillation (AF) among adults during single-time point rhythm screening performed during meetings or social recreational activities organized by patient groups or volunteers. A total of 2814 subjects (median age 68 years) underwent AF screening by a handheld single-lead ECG device (MyDiagnostick). Overall, 56 subjects (2.0%) were diagnosed with AF, as a result of 12-lead ECG following a positive/suspected recording. Screening identified AF in 2.9% of the subjects ≥ 65 years. None of the 265 subjects aged below 50 years was found positive at AF screening. Risk stratification for unknown AF based on a CHA2DS2VASc > 0 in males and >1 in females (or CHA2DS2VA > 0) had a high sensitivity (98.2%) and a high negative predictive value (99.8%) for AF detection. A slightly lower sensitivity (96.4%) was achieved by using age ≥ 65 years as a risk stratifier. Conversely, raising the threshold at ≥75 years showed a low sensitivity. Within the subset of subjects aged ≥ 65 a CHA2DS2VASc > 1 in males and >2 in females, or a CHA2DS2VA > 1 had a high sensitivity (94.4%) and negative predictive value (99.3%), while age ≥ 75 was associated with a marked drop in sensitivity for AF detection.

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FDG-PET in Hodgkin lymphoma

Nuklearmedizin ◽

10.3413/nukmed-0216 ◽

2008 ◽

Vol 47 (06) ◽

pp. 235-238 ◽

Cited By ~ 12

Author(s):

M. Dietlein ◽

C. Mauz-Körholz ◽

A. Engert ◽

P. Borchmann ◽

O. Sabri ◽

...

Keyword(s):

Hodgkin Lymphoma ◽

Negative Predictive Value ◽

Predictive Value ◽

Fdg Pet ◽

Study Groups ◽

Therapy Control ◽

German Study ◽

High Negative Predictive Value ◽

Consolidation Radiotherapy

SummaryThe high negative predictive value of FDG-PET in therapy control of Hodgkin lymphoma is proven by the data acquired up to now. Thus, the analysis of the HD15 trial has shown that consolidation radiotherapy might be omitted in PET negative patients after effective chemotherapy. Further response adapted therapy guided by PET seems to be a promising approach in reducing the toxicity for patients undergoing chemotherapy. The criteria used for the PET interpretation have been standardized by the German study groups for Hodgkin lymphoma patients and will be reevaluated in the current studies.

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381 Role of CT scans of abdomen and pelvis in management of patients with immunotherapy-induced colitis

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-sitc2020.0381 ◽

2020 ◽

Vol 8 (Suppl 3) ◽

pp. A406-A406

Author(s):

Juan Ibarra Rovira ◽

Raghunandan Vikram ◽

Selvi Thirumurthi ◽

Bulent Yilmaz ◽

Heather Lin ◽

...

Keyword(s):

Negative Predictive Value ◽

Clinical Diagnosis ◽

Predictive Value ◽

Clinical Symptoms ◽

Cytotoxic T Lymphocyte ◽

Checkpoint Inhibitors ◽

Ct Scans ◽

Wall Thickening ◽

Low Sensitivity ◽

Sensitivity Specificity

BackgroundColitis is one of the most common immune-related adverse event in patients who receive immune checkpoint inhibitors targeting cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death-1 (PD-1). Although radiographic changes are reported on computed tomography such as mild diffuse bowel thickening or segmental colitis, the utility of CT in diagnosis of patients with suspected immune-related colitis is not well studied.MethodsCT scans of the abdomen and pelvis of 34 patients on immunotherapy with a clinical diagnosis of immunotherapy induced colitis and 19 patients receiving immunotherapy without clinical symptoms of colitis (control) were enrolled in this retrospective study. Segments of the colon (rectum, sigmoid, descending, transverse, ascending and cecum) were assessed independently by two fellowship trained abdominal imaging specialists with 7 and 13 years‘ experience who were blinded to the clinical diagnosis. Each segment was assessed for mucosal enhancement, wall thickening, distension, peri-serosal fat stranding. Any disagreements were resolved in consensus. The degree of distension and the spurious assignment of wall thickening were the most common causes for disagreement. The presence of any of the signs was considered as radiographic evidence of colitis.ResultsCT evidence of colitis was seen in 16 of 34 patients with symptoms of colitis. 7 of 19 patients who did not have symptoms of colitis showed signs of colitis on CT. The sensitivity, specificity, Positive Predictive Value and Negative Predictive Value for colitis on CT is 47%, 63.2%, 69.5% and 40%, respectively.ConclusionsCT has a low sensitivity, specificity and negative predictive value for the diagnosis of immunotherapy-induced colitis. CT has no role in the diagnosis of patients suspected of having uncomplicated immune-related colitis and should not be used routinely for management.Trial RegistrationThis protocol is not registered on clinicaltrials.gov.Ethics ApprovalThis protocol was IRB approved on: 11/16/2015 - IRB 4 Chair Designee FWA #: 00000363 OHRP IRB Registration Number: IRB 4 IRB00005015ConsentThis protocol utilizes an IRB approved waiver of consent.

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Su1188 Transabdominal Ultrasound Has High Negative Predictive Value for Short-Term Complications of Inflammatory Bowel Disease

Gastroenterology ◽

10.1016/s0016-5085(15)31459-1 ◽

2015 ◽

Vol 148 (4) ◽

pp. S-432

Author(s):

Zuzana Zelinkova ◽

Barbora Kadleckova ◽

Beata Repakova

Keyword(s):

Inflammatory Bowel Disease ◽

Negative Predictive Value ◽

Bowel Disease ◽

Predictive Value ◽

Transabdominal Ultrasound ◽

Short Term ◽

High Negative Predictive Value ◽

Inflammatory Bowel

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Association between clinical risk scores and mortality in atrial fibrillation: Systematic review and network meta-regression of 669,000 patients

European Journal of Preventive Cardiology ◽

10.1177/2047487318817662 ◽

2018 ◽

Vol 27 (6) ◽

pp. 633-644 ◽

Cited By ~ 3

Author(s):

Marco Proietti ◽

Alessio Farcomeni ◽

Giulio Francesco Romiti ◽

Arianna Di Rocco ◽

Filippo Placentino ◽

...

Keyword(s):

Atrial Fibrillation ◽

Negative Predictive Value ◽

Predictive Value ◽

Predictive Ability ◽

Risk Scores ◽

Clinical Risk ◽

Increased Risk ◽

High Negative Predictive Value ◽

Meta Regression

Aims Many clinical scores for risk stratification in patients with atrial fibrillation have been proposed, and some have been useful in predicting all-cause mortality. We aim to analyse the relationship between clinical risk score and all-cause death occurrence in atrial fibrillation patients. Methods We performed a systematic search in PubMed and Scopus from inception to 22 July 2017. We considered the following scores: ATRIA-Stroke, ATRIA-Bleeding, CHADS2, CHA2DS2-VASc, HAS-BLED, HATCH and ORBIT. Papers reporting data about scores and all-cause death rates were considered. Results Fifty studies and 71 scores groups were included in the analysis, with 669,217 patients. Data on ATRIA-Bleeding, CHADS2, CHA2DS2-VASc and HAS-BLED were available. All the scores were significantly associated with an increased risk for all-cause death. All the scores showed modest predictive ability at five years (c-indexes (95% confidence interval) CHADS2: 0.64 (0.63–0.65), CHA2DS2-VASc: 0.62 (0.61–0.64), HAS-BLED: 0.62 (0.58–0.66)). Network meta-regression found no significant differences in predictive ability. CHA2DS2-VASc score had consistently high negative predictive value (≥94%) at one, three and five years of follow-up; conversely it showed the highest probability of being the best performing score (63% at one year, 60% at three years, 68% at five years). Conclusion In atrial fibrillation patients, contemporary clinical risk scores are associated with an increased risk of all-cause death. Use of these scores for death prediction in atrial fibrillation patients could be considered as part of holistic clinical assessment. The CHA2DS2-VASc score had consistently high negative predictive value during follow-up and the highest probability of being the best performing clinical score.

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Rectal screening displays high negative predictive value for bloodstream infection with (ESBL-producing) Gram-negative bacteria in neonates with suspected sepsis in a low-resource setting neonatal care unit

Journal of Global Antimicrobial Resistance ◽

10.1016/j.jgar.2020.08.017 ◽

2020 ◽

Vol 23 ◽

pp. 102-107

Author(s):

Annick Lenglet ◽

Jorien Schuurmans ◽

Cono Ariti ◽

Emily Borgundvaag ◽

Kessiane Charles ◽

...

Keyword(s):

Negative Predictive Value ◽

Bloodstream Infection ◽

Predictive Value ◽

Gram Negative Bacteria ◽

Suspected Sepsis ◽

Gram Negative ◽

Resource Setting ◽

Low Resource Setting ◽

High Negative Predictive Value ◽

Neonatal Care Unit

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Bloodstream infections in pediatric ECLS: usefulness of daily blood culture monitoring and predictive value of biological markers. The British Columbia experience

Pediatric Surgery International ◽

10.1007/s00383-008-2299-1 ◽

2009 ◽

Vol 25 (2) ◽

pp. 169-173 ◽

Cited By ~ 19

Author(s):

Gregor W. Kaczala ◽

Stephane C. Paulus ◽

Nawaf Al-Dajani ◽

Wilson Jang ◽

Edith Blondel-Hill ◽

...

Keyword(s):

British Columbia ◽

Blood Culture ◽

Biological Markers ◽

Predictive Value ◽

Bloodstream Infections ◽

Culture Monitoring

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Serum Angiotensin-Converting Enzyme Has a High Negative Predictive Value in the Investigation for Systemic Sarcoidosis

American Journal of Ophthalmology ◽

10.1016/j.ajo.2018.07.010 ◽

2018 ◽

Vol 194 ◽

pp. 82-87 ◽

Cited By ~ 13

Author(s):

Rachael L. Niederer ◽

Ahmed Al-Janabi ◽

Sue L. Lightman ◽

Oren Tomkins-Netzer

Keyword(s):

Angiotensin Converting Enzyme ◽

Negative Predictive Value ◽

Predictive Value ◽

Converting Enzyme ◽

Serum Angiotensin Converting Enzyme ◽

High Negative Predictive Value ◽

Systemic Sarcoidosis

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Incidence of Heparin-Induced Thrombocytopenia in Patients With Newly Implanted Mechanical Circulatory Support Devices

Annals of Pharmacotherapy ◽

10.1177/10600280211038705 ◽

2021 ◽

pp. 106002802110387

Author(s):

Long To ◽

Dana Attar ◽

Brittany Lines ◽

Melissa McCarty ◽

Hassan Nemeh ◽

...

Keyword(s):

Negative Predictive Value ◽

Predictive Value ◽

Mechanical Circulatory Support ◽

Serotonin Release ◽

Circulatory Support ◽

Anticoagulation Management ◽

Heparin Induced Thrombocytopenia ◽

Mechanical Circulatory Support Devices ◽

High Negative Predictive Value ◽

Release Assay

Background: Heparin exposure and device-related thrombocytopenia complicate the diagnosis of heparin-induced thrombocytopenia (HIT) in patients receiving mechanical circulatory support (MCS). To improve anticoagulation management for patients with newly implanted MCS devices, incidence of confirmed HIT needs to be further characterized. Objectives: The purpose of this study is to describe the incidence of HIT and clinical utility of the 4Ts score in patients with newly implanted MCS devices. Methods: This is a retrospective analysis of MCS patients receiving unfractionated heparin from 2014 to 2017. The primary end point was incidence of laboratory-confirmed HIT. Strong positive, likely positive, low probability, and negative HIT categories were established based on heparin-induced platelet antibody (HIPA) and serotonin release assay (SRA). Secondary end points include characterization of platelet trends, argatroban use, incidence of HIT among each of the MCS devices, and utility of 4Ts score. Results: A total of 342 patient encounters met inclusion criteria, of which 68 HIPA tests and 25 SRAs were ordered. The incidence of HIT was 0.88% (3/342) and 4.4% (3/68) in patients with suspected HIT. Of the 68 HIPA tests, 3 (4.4%) were considered strong positive and 3 of the 25 SRAs were positive. Median 4Ts score was 4 [2.5-4] and optical density 0.19 [0.11-0.54]. The positive predictive value for the 4Ts score was 0.15 (CI = 0.03-0.46) and negative predictive value, 0.93 (CI = 0.82-0.98). Conclusion and Relevance: HIT occurs infrequently with newly implanted MCS devices. The 4Ts score appears to have a high negative predictive value for ruling out HIT.

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