Improved Laboratory Diagnosis of Bacterial and Fungal Infections in Patients with Hematological Malignancies using PCR and Ribosomal RNA Sequence Analysis
- 26 August 2004
- journal article
- research article
- Published by Informa UK Limited in Leukemia & Lymphoma
- Vol. 45 (8), 1637-1641
- https://doi.org/10.1080/10428190410001667695
Abstract
During October 1999 to November 2000, 98 blood culture specimens from the same number of febrile episodes originating from 49 patients with hematological malignancies were examined for the presence of eubacteria and fungi based on 16S rRNA gene and the 5.8, 18 and 28S rRNA combined with in vitro PCR amplification and sequencing, in addition to conventional blood culture laboratory techniques. Nineteen of the samples were associated with positive blood cultures. Eubacterial (16S rRNA) PCR detected bacterial DNA in 26 febrile episodes, i.e. in an additional 7 febrile episodes than blood-culture alone. The species identified by partial 16S rRNA gene sequencing were as follows Staphylococcus spp (n = 6), Staphylococcus epidermidis (n = 5), Acinetobacter spp (n = 5), Escherichia coli (n = 2), Enterobacter agglomerans (n = 2), Campylobacter spp (n = 1), Citrobacter spp (n = 1), Corynebacterium spp (n = 1), Enterobacter faecium (n = 1), Ralstonia spp (n = 1), Acidovorax spp. (n = 1) and Stenotrophomonas maltophilia (n = 1). Gram-positive bacteria were found in 12/27 (44.6%) and gram-negative bacteria were found in 15/27 (55.6%). After optimization of a PCR-based fungal detection method, none of the febrile episodes were shown to be attributable to fungi. The results of this study suggest that fungi are not common causal agents of febrile episodes in patients with a hematological malignancy at this centre and that molecular techniques can augment cultural methods in the diagnosis of causal agents of bacteremia in patients, so that appropriate antibiotic regimens may be commenced in patients with culture-negative episodes of infection.Keywords
This publication has 16 references indexed in Scilit:
- Evolving concepts of management of febrile neutropenia in children with cancerMedical and Pediatric Oncology, 2002
- Risk Assessment Models and Contamination Management: Implications for Broad-Range Ribosomal DNA PCR as a Diagnostic Tool in Medical BacteriologyJournal of Clinical Microbiology, 2002
- Prospective screening by a panfungal polymerase chain reaction assay in patients at risk for fungal infections: implications for the management of febrile neutropeniaBritish Journal of Haematology, 2000
- Aspergillus terreus infections in haematological malignancies: molecular epidemiology suggests association with in-hospital plantsJournal of Hospital Infection, 2000
- Microbiological Findings in Febrile NeutropeniaArchives of Medical Research, 2000
- The spectrum of Fusarium infection in immunocompromised patients with haematological malignancies and in non‐immunocompromised patients: a single institution experience over 10 yearsBritish Journal of Haematology, 2000
- Bloodstream infections in children with cancer: a multicentre surveillance study of the Italian Association of Paediatric Haematology and OncologyEuropean Journal Of Cancer, 1999
- Detection ofPseudomonas (Burkholderia) cepacia using PCRPediatric Pulmonology, 1995
- Nucleotide sequence analysis of the 5·8S rDNA and adjacent ITS2 region of Candida albicans and related speciesYeast, 1993
- Management of Fever in Patients with Cancer and Treatment-Induced NeutropeniaNew England Journal of Medicine, 1993