Biography
Biography: Eiman Mokaddas
Abstract
Introduction: Sepsis is a fatal condition caused by body’s immune system over-reacting to infection. It carries both high morbidity and mortality. Early diagnosis of sepsis can greatly reduce both.
Objectives: To evaluate the comperative performance of Verigine blood culture nucliec acid system to conventional techniques in the rapid diagnosis of sepsis by both identifying bacteria and their resistance markers.
Methods: All blood culture bottles showing Gram-positive cocci and Gram-negative bacilli were processed by Verigene according to the manufacturer’s instructions and were cultured simultaneously by conventional methods for both ID as well as susceptibility using Vitek II( Biomerioux, France).
Results: A total of 63 patients with Gram-positive sepsis and 63 patients with Gram-negative sepsis were included in the evaluation. Verigine system correctly identified all stapylococcoci, streptococci and enterococci, Enterobacteriacae and Pseudomonase euroginosa compared to the conventional culture. It correctly identified 11 methicillin-susceptible Staphylococcus aureus ( MRSA) and 15 methicillin resistant coagulase negative staphylococci. It correctly identified one MRSA, failed to identify 2 and falsely identified 2. It correctly identified 11 vancomycin sensitive enterococci. By rapid identification of staphylococci together with their resistance markers, vancomycin was de-escalated to cloxacillin in 11 patients and cloxacillin was escalated to vancomycin in 2 and all antibiotics were stopped in 14 patients. By rapid identification of Gram-negative bacteria, de-escalation and escalation from and to carbapenems occurred in 2 and 20 patients respectively.
Conclusion: Rapid molecular diagnosis of sepsis can greatly assist in the proper use of antimicrobial agents hens, helping the antimicrobial stewardship program.