Diagnosis by real-time polymerase chain reaction of pathogens and antimicrobial resistance genes in bone marrow transplant patients with bloodstream infections

• Autor(a) principal: Menezes, Liana Carballo [UNIFESP]
• Data de Publicação: 2013
• Outros Autores: Rocchetti, Talita Trevizani [UNIFESP], Bauab, Karen de Castro [UNIFESP], Cappellano, Paola [UNIFESP], Quiles, Milene Goncalves [UNIFESP], Carlesse, Fabianne [UNIFESP], Oliveira, José Salvador Rodrigues de [UNIFESP], Pignatari, Antonio Carlos Campos [UNIFESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://repositorio.unifesp.br/handle/11600/36198; http://dx.doi.org/10.1186/1471-2334-13-166
• topic: Bone marrow transplants; Real-time polymerase chain reaction; Antibiotic resistance genes; Bloodstream infections

Background: Early identification of pathogens and antimicrobial resistance in bloodstream infections (BSIs) decreases morbidity and mortality, particularly in immunocompromised patients. the aim of the present study was to compare real-time polymerase chain reaction (PCR) with commercial kits for detection of 17 pathogens from blood culture (BC) and 10 antimicrobial resistance genes.Methods: A total of 160 BCs were taken from bone marrow transplant patients and screened with Gram-specific probes by multiplex real-time PCR and 17 genus-specific sequences using TaqMan probes and blaSHV, blaTEM, blaCTX, blaKPC, blaIMP, blaSPM, blaVIM, vanA, vanB, and mecA genes by SYBR Green.Results: Twenty-three of 33 samples identified by phenotypic testing were concordantly positive by BC and real-time PCR. Pathogen identification was discordant in 13 cases. in 12 of 15 coagulase-negative staphylococci, the mecA gene was detected and four Enterococcus spp. were positive for vanA. Two blaCTX and three blaSHV genes were found by quantitative PCR. the blaKPC and metallo-beta-lactamase genes were not detected. Five fungal species were identified only by real-time PCR.Conclusions: Real-time PCR could be a valuable complementary tool in the management of BSI in bone marrow transplants patients, allowing identification of pathogens and antimicrobial resistance genes.