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Critical Care
Published in: Critical Care 1/2011

01-02-2011 | Commentary

PCR for the diagnosis of sepsis: hope or hype?

Author: Jacques Schrenzel

Published in: Critical Care | Issue 1/2011

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Abstract

Molecular biology has not yet fully reached its ambitious goals in clinical bacteriology. Notwithstanding the tremendous technical challenges, the detection of nucleic acids directly from the blood of septic patients has not been shown cost-effective or even clinically relevant. Yet the potential for rapid molecular detection of circulating DNA (DNAemia) coupled to an educated antimicrobial drug adaptation has been repetitively advocated as a predicted breakthrough. Why do we still remain in such uncertainty?
Literature
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Lehmann LE, Herpichboehm B, Kost GJ, Kollef MH, Stüber F: Cost and mortality prediction using polymerase chain reaction pathogen detection in sepsis: evidence from three observational trials. Crit Care. 2010, 14: R186-10.1186/cc9294.PubMedPubMedCentralCrossRef
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Lehmann LE, Alvarez J, Hunfeld KP, Goglio A, Kost GJ, Louie RF, Raglio A, Regueiro BJ, Wissing H, Stuber F: Potential clinical utility of polymerase chain reaction in microbiological testing for sepsis. Crit Care Med. 2009, 37: 3085-3090. 10.1097/CCM.0b013e3181b033d7.PubMedCrossRef
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Ibrahim EH, Sherman G, Ward S, Fraser VJ, Kollef MH: The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest. 2000, 118: 146-155. 10.1378/chest.118.1.146.PubMedCrossRef
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Kollef MH, Sherman G, Ward S, Fraser VJ: Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest. 1999, 115: 462-474. 10.1378/chest.115.2.462.PubMedCrossRef
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Kumar A, Ellis P, Arabi Y, Roberts D, Light B, Parrillo JE, Dodek P, Wood G, Kumar A, Simon D, Peters C, Ahsan M, Chateau D: Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock. Chest. 2009, 136: 1237-1248. 10.1378/chest.09-0087.PubMed
Metadata
Title
PCR for the diagnosis of sepsis: hope or hype?
Author
Jacques Schrenzel
Publication date
01-02-2011
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2011
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc9378

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