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Evaluation of a PCR method to determine the clinical significance of blood cultures with Staphylococcus epidermidis in patients with hematological malignancies
Authors:Erik Ahlstrand  Anders Bäckman  Lennart Persson  Paula Mölling  Ulf Tidefelt  Bo Söderquist
Affiliation:1. Department of Medicine, Hematology, ?rebro University Hospital, , ?rebro, Sweden;2. Faculty of Medicine and Health, ?rebro University, , ?rebro, Sweden;3. Clinical Research Centre, ?rebro University Hospital, , ?rebro, Sweden;4. Department of Infectious diseases, ?rebro University Hospital, , ?rebro, Sweden;5. Department of Laboratory Medicine, Clinical Microbiology, ?rebro University Hospital, , ?rebro, Sweden
Abstract:The aim was to investigate whether the detection and quantification of Staphylococcus epidermidis DNA in blood could distinguish S. epidermidis blood stream infections (BSIs) from blood culture contaminations in patients with hematological malignancies. The hld gene was chosen to identify S. epidermidis DNA and DNA in blood samples was detected by real‐time PCR. Blood samples were obtained simultaneously with blood cultures positive for S. epidermidis (n = 30), during blood culture‐negative episodes (n = 10) and episodes of bacteremia with other bacteria than S. epidermidis (n = 4) and from healthy blood donors (n = 10). In addition, DNA from S. epidermidis and a selection of other bacterial species were analyzed. Three different sets of criteria were used to classify episodes with positive blood cultures with S. epidermidis as BSIs or contaminations. All DNA preparations from S. epidermidis (n = 48) were hld‐positive, but other bacterial species (n = 13) were negative. Sixteen (53%) of 30 blood samples from patients with blood cultures positive for S. epidermidis were hld‐positive, but none of the controls. There was no clear association between a positive hld PCR and episodes interpreted as BSIs. In conclusion, hld PCR failed to distinguish S. epidermidis BSIs from blood culture contaminations in patients with hematological malignancies.
Keywords:Coagulase‐negative staphylococci     Staphylococcus epidermidis     hematological malignancy  blood culture contamination
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