Evaluation of PCR for Detection of Blood Stream Infections in Critical Oncology Patients | ||
| Egyptian Journal of Medical Microbiology | ||
| Articles in Press, Accepted Manuscript, Available Online from 11 October 2025 | ||
| Document Type: New and original researches in the field of Microbiology. | ||
| DOI: 10.21608/ejmm.2025.429322.1909 | ||
| Authors | ||
| Hossam Zaghloul1; Walaa O. Elshabrawy1; Sameh S. Shamaa2; Shimaa M. Khater* 1 | ||
| 1Department of Clinical Pathology, Microbiology Unit, Faculty of Medicine, Mansoura University, Egypt | ||
| 2Department of Medical Oncology, Faculty of Medicine, Mansoura University, Egypt | ||
| Abstract | ||
| Background: Blood stream infections (BSIs) are common among cancer patients undergoing intensive chemotherapy and hematopoietic stem cell transplantation (HSCT). Early diagnosis and treatment are vital to reduce morbidity and mortality. Current diagnostic tools such as blood culture suffers from low sensitivity and long turn-around time (TAT). Real-time PCR offers a more rapid and sensitive molecular diagnostic technique in detection and diagnosis of sepsis in critical oncology patients. The aim of the study: to evaluate the role of PCR in the detection and diagnosis of sepsis in critical oncology patients. Methodology: Sepsis 3 criteria was used to assess presence of sepsis in one hundred critical oncology patients participating in our study. Blood stream infections were detected using both automated blood culture and real-time PCR. The study was done on 39 male and 61 female ranging in age from 19 to 76years, all are cancer patients with hematological malignancies, hematopoietic stem cell transplanted patients, solid malignancies post-operative or with complication and cancer patients with metastasis. Results: Real-time PCR targeting 16S r RNA for detection of bacteria demonstrated sensitivity 92.1% specificity 88.1%, positive predictive value 97.6% and negative predictive value 56.3% and accuracy of 91% in diagnosis of sepsis. Also, 18S r RNA PCR detected 7 cases of fungal infections versus no case detected by automated blood culture. Staphylococcus aureus (63.9%) was the most common organism isolated by blood culture followed by klebsiella pneumoniae (8.2%). According to outcome about 55% of the oncology patients needed ICU admission. There was a statistically significant difference between improved patients and patients with poor outcome regarding lactate. Conclusion: Real -time PCR for 16S rRNA or 18S rRNA showed rapid and accurate diagnostic molecular technique with higher sensitivity than blood culture in detection of blood stream infection in oncology patients. Staphylococcus aureus was the most common organism isolated by blood culture followed by klebsiella pneumoniae. Lactate was found to have good sensitivity and specificity in predicting poor outcome at levels>2 mmol/l. | ||
| Keywords | ||
| Cancer; sepsis; outcome; ICU; lactate | ||
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