Challenging Clinicians and Medical Microbiologists to reconsider sepsis management
Lisa Simms [1], David Farlow [1][2], Matthew I. Hiskens [2] , Tesfaye S. Mengistu [2], Nicolas Sieben [2], Brian McPherrin [2], Janath De Silva [2], Ron Nightingale [2], Karen Smith [2], Corey Davies [1], Nadeesha Jayasundara [1], Sumeet Sandhu [1], Alex Pintara [1], Raffaella Giardino [1], Flavia Huygens [1]
Results
S. pneumoniae infection was detected in 19 patients using InfectID-BSI. Significantly, in each of these 19 patients, BC reported no growth. Nearly 50% of patients (9/19) with S. pneumoniae detections had clinical or radiological evidence of a pneumonic process or significant respiratory distress. Four of 19 (21.1%) patients had a diagnosis of urosepsis with Escherichia coli. Three of four patients had polymicrobial infection with low quantities of S. pneumoniae. Clinical concordance indicated that 80% of S. pneumoniae detections were likely the primary/secondary cause of sepsis. Rare clinical presentations (supported by the literature) included two patients with cellulitis, one with rhabdomyolysis, and one with appendicitis.
Table 1: An exemplar of polymicrobial infections with S. pneumoniae in four patients with a primary diagnosis of urosepsis, including Quantitation. S. pneumoniae infections were not detected by blood culture.
| Patient ID | Blood culture result | InfectID-BSI result [Quant: # genome copies / 0.35 mL blood] |
|---|---|---|
| MB5 | E. coli | E. coli [676*] S. pneumoniae [201] |
| MB13** | No growth | E. coli [676*] S. pneumoniae [201] |
| MB14 | No growth | E. coli [869] S. pneumoniae [95] |
| MB39** | No growth | E. coli [17,583*] S. pneumoniae [7] |
*Mean values from replicate samples; **These patients have evidence of prior antibiotic exposure
Reference
