TY - JOUR
T1 - Potential of Molecular Culture in Early Onset Neonatal Sepsis Diagnosis
T2 - A Proof of Principle Study
AU - Dierikx, Thomas
AU - Budding, Andries
AU - Bos, Martine
AU - van Laerhoven, Henriëtte
AU - van der Schoor, Sophie
AU - Niemarkt, Hendrik
AU - Benninga, Marc
AU - van Kaam, Anton
AU - Visser, Douwe
AU - de Meij, Tim
N1 - Funding Information: This work was supported by the foundation of medical research of the OLVG, Amsterdam, The Netherlands; the Amsterdam Reproduction & Development research institute, Amsterdam, the Netherlands; by Stichting Zeldzame Ziektefonds (ZZF); and the De For Wis(h)dom Foundation. These funding sources had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication. Publisher Copyright: © 2023 by the authors.
PY - 2023/4/1
Y1 - 2023/4/1
N2 - Delay in the time-to-positivity of a peripheral blood culture (PBC), the gold standard for early onset neonatal sepsis (EOS) diagnosis, has resulted in excessive use of antibiotics. In this study, we evaluate the potential of the rapid Molecular Culture (MC) assay for quick EOS diagnosis. In the first part of this study, known positive and spiked blood samples were used to assess the performance of MC. In the in vivo clinical study, the second part of this study, all infants receiving antibiotics for suspicion of EOS were included. At initial EOS suspicion, a blood sample was collected for PBC and MC. MC was able to detect bacteria present in the spiked samples even when the bacterial load was low. In the clinical study, MC was positive in one infant with clinical EOS (Enterococcus faecalis) that was not detected by PBC. Additionally, MC was positive in two infants without clinical sepsis (Streptococcus mitis and multiple species), referred to as contamination. The other 37 samples were negative both by MC and PBC. MC seems to be able to detect bacteria even when the bacterial load is low. The majority of MC and PBC results were comparable and the risk for contamination and false positive MC results seems to be limited. Since MC can generate results within 4 h following sampling compared with 36–72 h in PBC, MC may have the potential to replace conventional PBC in EOS diagnostics in order to guide clinicians on when to discontinue antibiotic therapy several hours after birth.
AB - Delay in the time-to-positivity of a peripheral blood culture (PBC), the gold standard for early onset neonatal sepsis (EOS) diagnosis, has resulted in excessive use of antibiotics. In this study, we evaluate the potential of the rapid Molecular Culture (MC) assay for quick EOS diagnosis. In the first part of this study, known positive and spiked blood samples were used to assess the performance of MC. In the in vivo clinical study, the second part of this study, all infants receiving antibiotics for suspicion of EOS were included. At initial EOS suspicion, a blood sample was collected for PBC and MC. MC was able to detect bacteria present in the spiked samples even when the bacterial load was low. In the clinical study, MC was positive in one infant with clinical EOS (Enterococcus faecalis) that was not detected by PBC. Additionally, MC was positive in two infants without clinical sepsis (Streptococcus mitis and multiple species), referred to as contamination. The other 37 samples were negative both by MC and PBC. MC seems to be able to detect bacteria even when the bacterial load is low. The majority of MC and PBC results were comparable and the risk for contamination and false positive MC results seems to be limited. Since MC can generate results within 4 h following sampling compared with 36–72 h in PBC, MC may have the potential to replace conventional PBC in EOS diagnostics in order to guide clinicians on when to discontinue antibiotic therapy several hours after birth.
KW - IS-pro
KW - diagnosis
KW - early onset sepsis
KW - molecular culture
KW - neonates
UR - http://www.scopus.com/inward/record.url?scp=85156248563&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/microorganisms11040960
DO - https://doi.org/10.3390/microorganisms11040960
M3 - Article
C2 - 37110382
SN - 2076-2607
VL - 11
JO - Microorganisms
JF - Microorganisms
IS - 4
M1 - 960
ER -