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Master Thesis

Évaluation des performances microbiologiques et de l'impact pré-clinique potentiel de la PCR multiplexe ePlex-BCID® (GenMark Diagnostics) pour le diagnostic rapide des bactériémies et fongémies: Hemofast I

Abstract : Introduction: Novel rapid diagnosis tools are needed to improve the outcome of bloodstream infections (BSI), as conventional diagnosis techniques currently need 24 to 48 hours to yield a complete result (of both identification and antimicrobial susceptibility testing). Methods: The ePlex-BCID® system is a multiplex PCR performing identification in 1.5 hours of 56 bacterial and fungal targets, along with 10 resistance markers, directly from positive blood culture bottles. We assessed its microbiological performances on 187 BSI episodes of bacteraemia and fungemia. Retrospective analysis of its potential clinical impact has also been determined for 158 of these episodes. Results: A global agreement rate of 93% has been found for the ePlex® multiplex PCR method compared to our current diagnosis strategy after exclusion of off-panel and true positive results. All samples together, correct identification to the genus and species level was found respectively in 173/187 (92.5%) and 148/187 (79%) of the BSI episodes. 100% of the resistance markers were detected. All the micro-organisms were correctly identified to the genus level in 87.5% of the polymicrobial blood cultures. The empiric anti-microbial treatment would have been modified in 45% of the episodes based on the results of the test. The test would have misled the clinician’s decision in 4.4% of the episodes. Conclusion: The ePlex-BCID® system showed promising microbiological performances and potential clinical impact, that still needs to be confirmed in a prospective randomized trial.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02481807
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Submitted on : Monday, February 17, 2020 - 4:35:15 PM
Last modification on : Wednesday, July 15, 2020 - 8:58:04 AM
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  • HAL Id : dumas-02481807, version 1

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Sabrina Bryant. Évaluation des performances microbiologiques et de l'impact pré-clinique potentiel de la PCR multiplexe ePlex-BCID® (GenMark Diagnostics) pour le diagnostic rapide des bactériémies et fongémies: Hemofast I. Médecine humaine et pathologie. 2019. ⟨dumas-02481807⟩

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