October, 2018

Tinzar Basein, Bradley J Gardiner,  Gabriela M Andujar Vazquez,  Andrew S Joel Chandranesan,  Arthur R Rabson,  Shira Doron, David R Snydman

Open Forum Infect Dis. 2018 Oct 10;5(11):ofy257
PMID: 30539032 | PMCID: PMC6284463| DOI:10.1093/ofid/ofy257

Abstract

Broad-range polymerase chain reaction (PCR) is increasingly used in patients with culture-negative infections; however, few studies have assessed the diagnostic utility of this test in this context. We performed a retrospective cohort study of patients who had clinical specimens sent for broad-range PCR, aiming to evaluate performance and determine impact on patient management. Organisms were identified in 21/71 samples. High numbers of polymorphonuclear leukocytes on Gram stain (odds ratio [OR], 4.17; P = .04) and acute inflammation on histopathology (OR, 5.69; P = .02) were significantly associated with a positive result. Management was altered in 18 patients, 11 with positive and 7 with negative results. Overall, broad-range PCR assay had the highest impact in patients with microscopic evidence of inflammation. Physicians ordering this complex, difficult to interpret, and expensive test should carefully consider all available clinical information on an individualized basis to optimize its performance.

Source: https://academic.oup.com/ofid/article/5/11/ofy257/5125684