Objective: The rapid detection of blood stream infection has the potential to not only improve patient outcomes due to quicker administration of appropriate antibiotics but also improve antibiotic stewardship by reducing patient exposures to ineffective or unnecessary broad-spectrum antibiotics . Methods: In this study blood samples from acute leukemia neutropenic patients (samples under study) and non neutropenic patients (control) were tested using cultural and non-cultural based techniques via blood culture, C-reactive protein (CRP), Erythrocyte sedimentation rate (ESR) and Molecular techniques (bacterial 16S rDNA analysis). Results: About 22% & 15% were shown positive in blood culturing ; 94% & 85% were positive for CRP ; 86% and 75% were presented by elevation in ESR rate for the first hour ; 94% and 80% were presented by elevation in ESR rate for second hour. Treatment response of the positive cases by blood culture only was found to be 72.7% and 100% not in remission for samples under study and control respectively. In cases under study there is statistically significant correlation between culture growth sensitivity and PCR technique with P value < 0.005.
Potgieter, M., Bester, J., Kell, D.B. and Pretorius, E. (2015) The Dormant Blood Microbiome in Chronic, Inflammatory Diseases. FEMS Microbiology Reviews, 39, 567-591. https://doi.org/10.1093/femsre/fuv013
De Naurois, J., Novitzky-Basso, I., Gill, M.J., Marti, F.M., Cullen, M.H., Roila, F. and ESMO Guidelines Working Group (2010) Management of Febrile Neutropenia: ESMO Clinical Practice Guidelines. Annals of Oncology, 21, v252-v256. https://doi.org/10.1093/annonc/mdq196
Moghnieh, R., Kanafani, Z.A., Abi Hanna, P., Matar, M.J., Mokhbat, J., Jradeh, M., Choucair, J., et al. (2017) 2016 Lebanese Society of Infectious Diseases and Clinical Microbiology Guidelines on the Management of Febrile Neutropenia in Adult Cancer Patients in the Era of Growing Antimicrobial Resistance. Lebanese Medical Journal, 103, 1-20. https://doi.org/10.12816/0038540
Anderson, K., Bradford, N., Edwards, R., Nicholson, J., Lockwood, L. and Clark, J. (2019) Addressing the Barriers to Optimal Management of Febrile Neutropenia in Children with Cancer. European Journal of Oncology Nursing, 45, Article ID: 101719. https://doi.org/10.1016/j.ejon.2019.101719
Kalich, B.A., Maguire, J.M., Campbell-Bright, S.L., Mehrotra, A., Caffey, T., Tulu, Z., Carson, S.S., et al. (2016) Impact of an Antibiotic-Specific Sepsis Bundle on Appropriate and Timely Antibiotic Administration for Severe Sepsis in the Emergency Department. The Journal of Emergency Medicine, 50, 79-88. https://doi.org/10.1016/j.jemermed.2015.09.007
Gyarmati, P., Kjellander, C., Aust, C., Song, Y., Ohrmalm, L. and Giske, C.G. (2016) Metagenomic Analysis of Bloodstream Infections in Patients with Acute Leukemia and Therapy-Induced Neutropenia. Scientific Reports, 6, Article No. 23532. https://doi.org/10.1038/srep23532
Liese, J.G., Schoen, C., van der Linden, M., Lehmann, L., Goettler, D., Keller, S., Streng, A., et al. (2019) Changes in the Incidence and Bacterial Aetiology of Paediatric Parapneumonic Pleural Effusions/Empyema in Germany, 2010-2017: A Nationwide Surveillance Study. Clinical Microbiology and Infection, 25, 857-864. https://doi.org/10.1016/j.cmi.2018.10.020
Ronkko, R., Juutilainen, A., Koivula, I., Vanska, M., Nousiainen, T., Jantunen, E. and Hamalainen, S. (2018) Changes in the Microbiological Epidemiology of Febrile Neutropenia in Autologous Stem Cell Transplant Recipients. Infectious Diseases, 50, 436-442. https://doi.org/10.1080/23744235.2017.1420221
Ohrmalm, L., Wong, M., Aust, C., Ljungman, P., Norbeck, O., Broliden, K. and Tolfvenstam, T. (2012) Viral Findings in Adult Hematological Patients with Neutropenia. PLoS ONE, 7, e36543. https://doi.org/10.1371/journal.pone.0036543
Chalmers, S.J. and Wylam, M.E. (2020) Methicillin-Resistant Staphylococcus aureus Infection and Treatment Options. In: Methicillin-Resistant Staphylococcus aureus (MRSA) Protocols, Humana, New York, 229-251. https://doi.org/10.1007/978-1-4939-9849-4_16
Bard, J.D. and TeKippe, E.M. (2016) Diagnosis of Bloodstream Infections in Children. Journal of Clinical Microbiology, 54, 1418-1424. https://doi.org/10.1128/JCM.02919-15
Dellinger, R.P., Levy, M.M., Rhodes, A., Annane, D., Gerlach, H., Opal, S.M., Osborn, T.M., et al. (2013) Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock, 2012. Intensive Care Medicine, 39, 165-228. https://doi.org/10.1007/s00134-012-2769-8
Jordana-Lluch, E., Rivaya, B., Marcó, C., Giménez, M., Quesada, M.D., Escobedo, A., Ausina, V., et al. (2017) Molecular Diagnosis of Bloodstream Infections in Onco-Haematology Patients with PCR/ESI-MS Technology. Journal of Infection, 74, 187-194. https://doi.org/10.1016/j.jinf.2016.11.011
Liesenfeld, O., Lehman, L., Hunfeld, K.P. and Kost, G. (2014) Molecular Diagnosis of Sepsis: New Aspects and Recent Developments.
Firoozeh, F., Shiralinezhad, A., Momen-Heravi, M., Aghadavod, E. and Zibaei, M. (2019) Rapid Detection of Pathogenic Bacteria in Whole Blood Samples Using 23S rRNA PCR Assays. The Open Microbiology Journal, 13, 101-105. https://doi.org/10.2174/1874285801913010101
Murphy, L., Davidson, S., Chase, J.G., Knopp, J.L., Zhou, T. and Desaive, T. (2020) Patient-Specific Monitoring and Trend Analysis of Model-Based Markers of Fluid Responsiveness in Sepsis: A Proof-of-Concept Animal Study. Annals of Biomedical Engineering, 48, 682-694. https://doi.org/10.1007/s10439-019-02389-9
Lacoma, A., Rodríguez, N., Prat, C., Ruiz-Manzano, J., Andreo, F., Ramírez, A., Domínguez, J., et al. (2012) Usefulness of Consecutive Biomarkers Measurement in the Management of Community-Acquired Pneumonia. European Journal of Clinical Microbiology & Infectious Diseases, 31, 825-833. https://doi.org/10.1007/s10096-011-1381-0
Marshall, A.C., Castellanos, T.G., Motas, I.M., Rodriguez, D.S., Romaní, M.E.T. and ávila, J.P. (2014) Utility of C-Reactive Protein and Procalcitonin for Detecting Bloodstream Infection in Patients with HIV/AIDS. World Journal of AIDS, 4, 287. https://doi.org/10.4236/wja.2014.43033
Mori, Y., Miyawaki, K., Kato, K., Takenaka, K., Iwasaki, H., Harada, N., Teshima, T., et al. (2011) Diagnostic Value of Serum Procalcitonin and C-Reactive Protein for Infections after Allogeneic Hematopoietic Stem Cell Transplantation versus Nontransplant Setting. Internal Medicine, 50, 2149-2155. https://doi.org/10.2169/internalmedicine.50.5798
Mancini, N., Carletti, S., Ghidoli, N., Cichero, P., Burioni, R. and Clementi, M. (2010) The Era of Molecular and Other Non-Culture-Based Methods in Diagnosis of Sepsis. Clinical Microbiology Reviews, 23, 235-251. https://doi.org/10.1128/CMR.00043-09
Paolucci, M., Landini, M.P. and Sambri, V. (2010) Conventional and Molecular Techniques for the Early Diagnosis of Bacteraemia. International Journal of Antimicrobial Agents, 36, S6-S16. https://doi.org/10.1016/j.ijantimicag.2010.11.010
Avni, T., Mansur, N., Leibovici, L. and Paul, M. (2010) PCR Using Blood for Diagnosis of Invasive Pneumococcal Disease: Systematic Review and Meta-Analysis. Journal of Clinical Microbiology, 48, 489-496. https://doi.org/10.1128/JCM.01636-09
Book, M., Lehmann, L.E., Zhang, X. and Stüber, F. (2013) Monitoring Infection: From Blood Culture to Polymerase Chain Reaction (PCR) Best Practice & Research. Clinical Anaesthesiology, 27, 279-288. https://doi.org/10.1016/j.bpa.2013.06.010
Chastain, D.B., Wheeler, S., Franco-Paredes, C., Olubajo, B. and Hawkins, W.A. (2018) Evaluating Guideline Adherence Regarding Empirical Vancomycin Use in Patients with Neutropenic Fever. International Journal of Infectious Diseases, 69, 88-93. https://doi.org/10.1016/j.ijid.2018.02.016
Almyroudis, N.G., Osawa, R., Samonis, G., Wetzler, M., Wang, E.S., McCarthy, P.L. and Segal, B.H. (2016) Discontinuation of Systematic Surveillance and Contact Precautions for Vancomycin-Resistant Enterococcus (VRE) and Its Impact on the Incidence of VRE Faecium Bacteremia in Patients with Hematologic Malignancies. Infection Control & Hospital Epidemiology, 37, 398-403. https://doi.org/10.1017/ice.2015.310