Article

Adjuvant role of SeptiFast to improve the diagnosis of sepsis in a large cohort of hematological patients

  • Bone Marrow Transplantationvolume 53pages410416 (2018)
  • doi:10.1038/s41409-017-0039-7
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Abstract

Febrile neutropenia and sepsis are common and life-threatening complications in hematological diseases. This study was performed retrospectively in 514 patients treated for febrile neutropenia at our institute, to investigate the clinical usefulness of a molecular tool, LightCycler® SeptiFast test (SF), to promptly recognize pathogens causing sepsis in hematological patients. We collected 1837 blood samples of 514 consecutive hematological patients. The time of processing is short. Overall, 757 microorganisms in 663 episodes were detected by molecular test and standard blood cultures (BC): 73.6% Gram-positive bacteria, 23.9% Gram-negative bacteria, and 2.5% fungal species. This large analysis demonstrated a significant episode-to episode agreement (71.9%) between the two methods, higher in negative samples (89.14%), and a specificity of 75.89%. Clinical variables that gave a statistically significant contribution to their concordance were absolute neutrophil count, ongoing antimicrobial therapy, timing of test execution, and organ localization of infection. The large analysis highlights the potential of molecular-based assays directly performed on blood samples, especially if implementing the detection of antibiotic resistance genes, which was lacking in the used study.

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Acknowledgements

Support was provided by the Italian Ministry of Health, University and Research.

Author contributions

R.G, M.C.B, N.M, M.C, and F.C. conceived the study, analyzed data and wrote the manuscript. All authors carried out the collection of patient information and provided clinical care. All authors read and approved the final manuscript.

Author information

Author notes

  1. Raffaella Greco, Maria Chiara Barbanti, Massimo Clementi and Fabio Ciceri contributed equally to this work.

Affiliations

  1. Hematology and BMT Unit, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132, Milano, Italy

    • Raffaella Greco
    • , Maria Chiara Barbanti
    • , Lara Crucitti
    • , Alessandra Forcina
    • , Francesca Lorentino
    • , Luca Vago
    • , Carlo Messina
    • , Daniela Clerici
    • , Mara Morelli
    • , Fabio Giglio
    • , Maria Teresa Lupo Stanghellini
    • , Matteo G. Carrabba
    • , Sarah Marktel
    • , Andrea Assanelli
    • , Massimo Bernardi
    • , Jacopo Peccatori
    • , Consuelo Corti
    •  & Fabio Ciceri
  2. Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milano, Italy

    • Nicasio Mancini
    • , Laura Infurnari
    •  & Massimo Clementi
  3. Università degli Studi di Milano, Milano, MI, Italy

    • Lara Crucitti
  4. Infectious Disease Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy

    • Chiara Oltolini
  5. Unit of Immunogenetics, Leukemia Genomics and Immunobiology IRCCS San Raffaele Scientific Institute, Milano, Italy

    • Luca Vago
    •  & Paolo Scarpellini
  6. University Vita-Salute, via Olgettina 48, 20132, Milano, Italy

    • Massimo Clementi
    •  & Fabio Ciceri

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Conflict of interest

The authors declare that they have no conflict of interest.

Corresponding author

Correspondence to Fabio Ciceri.