Background
Bacterial sepsis is a very severe infection, potentially lethal, that requires an etiologic diagnosis and fairly complex treatment, quickly set. Plex-ID is the newest method in etiologic diagnoses of bacterial infections. It can detect bacterial DNA found in various pathological products: blood, CSF, joint fluid, pleural liquid.
Methods
We conducted a 6-month study from January to June 2012 on children admitted to our pediatric ICU of the National Institute of Infectious Diseases for severe forms of bacterial sepsis. In these children we monitored the following parameters: sex, age and origin (nosocomial or community-acquired infection). Positive diagnosis of sepsis was established on clinical and laboratory criteria (hemocultures, CSF cultures). As well as classical cultures, we found causal agents through the newest modern technique - Plex-ID. We watched for correlation of data obtained by classical methods versus molecular methods and the clinical and biological evolution of patients under treatment
Results
In the 6 months of study, 21 children met the clinical and biological criteria for bacterial sepsis. Seventy-six percent of patients came from other hospitals, the reason for which we consider that the etiology is most probably nosocomial pathogens. Sex distribution was approximately equal boys and girls, and in terms of distribution by age group prevailed in children aged 0 to 3 years (80%). We obtained 15 positive results (71%) by molecular methods that were correlated with conventional methods of diagnosis. The seat in the distribution of case etiology was as follows: Niessiera meningitides (four cases), Streptococcus pneumoniae (two cases), Staphylococcus spp. (four cases), Klebsiella pneumoniae (one case), Acinetobacter baumannii (one case), Pseudomonas aeruginosa (one case), Propionibacterium acnes (one case), and Haemophilus influenzae (one case).
Conclusion
Bacterial sepsis in children is a serious condition resulting in four deaths (19%) with septic shock and multiple organ failure in our study. The patients require rapid etiologic diagnosis and establishment of appropriate emergency treatment. Plex-ID is an effective and rapid diagnosis method, identifying casual agent in 71% of cases.
The major advantage of this new method is the possibility to establish the etiological diagnosis in the early hours of patient admission. Also the speed and specificity of the modern diagnosis methods increase the survival index of the hospitalized patients with severe bacterial sepsis.
Author information
Authors and Affiliations
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
Merisescu, M., Luminos, M., Jugulete, G. et al. Molecular diagnosis of severe bacterial sepsis in children. Crit Care 16 (Suppl 3), P67 (2012). https://doi.org/10.1186/cc11754
Published:
DOI: https://doi.org/10.1186/cc11754