Ribosomal RNA-based panbacterial polymerase chain reaction for rapid diagnosis of septicaemia in Intensive Care Unit patients

ABSTRACT Introduction: Candida spp is an emerging cause of blood stream infections worldwide. Delay in speciation of Candida isolates by conventional methods and resistance to antifungal drugs (especially fluconazole, amphotericin B, etc.) in various Candida species are some of the factors responsible for the increase in morbidity and mortality due to candidemia. So, the rapid detection and identification of Candida isolates from blood is very important for the proper management of patients having candidemia. Materials and Methods: In this study, we have used polymerase chain reaction (PCR) - restriction fragment length polymorphism (RFLP) as a method for the speciation of Candida isolates from blood samples of intensive care unit (ICU) patients. PCR was used to amplify the ITS-1 and ITS-2 regions of Candida spp using universal primers ITS-1 and ITS-4. The amplified product was digested using Msp I restriction enzyme by RFLP. Results and Discussion: The method PCR-RFLP helped in identifying five medically important Candida spp (C. tropicalis, C. albicans, C. parapsilosis, C. krusei and C. glabrata) from blood. This method is rapid, reliable, easy and cost-effective and can be used in routine laboratory diagnostics for the rapid identification of Candida isolates from blood. Conclusion: PCR-RFLP is an easy, rapid and highly valuable tool which can be used in routine diagnostic laboratories to speciate Candida isolates obtained from blood. This rapid method of speciation will help clinicians to decide on empirical therapy in candidemia cases before antifungal susceptibility results are available.

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Comparison of Candida Polymerase Chain Reaction Method and Blood Culture in Patients with High Risk of Candidemia in Intensive Care Unit

Mikrobiyoloji Bulteni ◽

10.5578/mb.20219708 ◽

2021 ◽

Vol 55 (4) ◽

pp. 568-579

Author(s):

Tuğçe Şimşek Bozok ◽

Ferit Kuşcu ◽

Taylan Bozok ◽

Süheyla Kömür ◽

Aslıhan Candevir ◽

...

Keyword(s):

Intensive Care Unit ◽

Polymerase Chain Reaction ◽

Intensive Care ◽

High Risk ◽

Blood Culture ◽

Polymerase Chain Reaction Method ◽

Chain Reaction ◽

Reaction Method ◽

Polymerase Chain

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Effect of rapid methicillin-resistant Staphylococcus aureus nasal polymerase chain reaction screening on vancomycin use in the intensive care unit

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxab296 ◽

2021 ◽

Author(s):

Calvin Diep ◽

Lina Meng ◽

Samaneh Pourali ◽

Matthew M Hitchcock ◽

William Alegria ◽

...

Keyword(s):

Intensive Care Unit ◽

Staphylococcus Aureus ◽

Polymerase Chain Reaction ◽

Intensive Care ◽

Length Of Stay ◽

Methicillin Resistant Staphylococcus Aureus ◽

Chain Reaction ◽

Polymerase Chain ◽

Secondary Outcomes ◽

Suspected Pneumonia

Abstract Purpose To determine the impact of a pharmacist-driven methicillin-resistant Staphylococcus aureus (MRSA) nasal polymerase chain reaction (PCR) screen on vancomycin duration in critically ill patients with suspected pneumonia. Methods This was a retrospective, quasi-experimental study at a 613-bed academic medical center with 67 intensive care beds. Adult patients admitted to the intensive care unit (ICU) between 2017 and 2019 for 24 hours or longer and empirically started on intravenous vancomycin for pneumonia were included. The primary intervention was the implementation of a MRSA nasal PCR screen protocol. The primary outcome was duration of empiric vancomycin therapy. Secondary outcomes included the rate of acute kidney injury (AKI), the number of vancomycin levels obtained, the rate of resumption of vancomycin for treatment of pneumonia, ICU length of stay, hospital length of stay, the rate of ICU readmission, and the rate of in-hospital mortality. Results A total of 418 patients were included in the final analysis. The median vancomycin duration was 2.59 days in the preprotocol group and 1.44 days in the postprotocol group, a reduction of approximately 1.00 day (P < 0.01). There were significantly fewer vancomycin levels measured in the postprotocol group than in the preprotocol group. Secondary outcomes were similar between the 2 groups, except that there was lower AKI and fewer vancomycin levels obtained in the postprotocol group (despite implementation of area under the curve–based vancomycin dosing) as compared to the preprotocol group. Conclusion The implementation of a pharmacist-driven MRSA nasal PCR screen was associated with a decrease in vancomycin duration and the number of vancomycin levels obtained in critically ill patients with suspected pneumonia.

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