Digital PCR applications for the diagnosis and management of infection in critical care medicine

Infection (either community acquired or nosocomial) is a major cause of morbidity and mortality in critical care medicine. Sepsis is present in up to 30% of all ICU patients. A large fraction of sepsis cases is driven by severe community acquired pneumonia (sCAP), which incidence has dramatically in...

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Vydané v:Critical care (London, England) Ročník 26; číslo 1; s. 63 - 10
Hlavní autori: Merino, Irene, de la Fuente, Amanda, Domínguez-Gil, Marta, Eiros, José María, Tedim, Ana P., Bermejo-Martín, Jesús F.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: London BioMed Central 21.03.2022
BioMed Central Ltd
Springer Nature B.V
BMC
Predmet:
Antimicrobial agents
Bacterial pneumonia
Care and treatment
Community-acquired infections
Coronaviruses
COVID-19
COVID-19 - diagnosis
Critical Care
Critical Care Medicine
Critically ill patients
Diagnosis
Digital PCR
Drug resistance
Emergency Medicine
Evaluation
Host response
Humans
Identification
Infection diagnosis
Infectious diseases
Intensive
Intensive care
Management
Medical diagnosis
Medical prognosis
Medicine
Medicine & Public Health
Methods
Microorganisms
Nosocomial infections
Pandemics
Pathogens
Patients
Pneumonia
Polymerase chain reaction
Prognosis and treatment guidance
Real-Time Polymerase Chain Reaction - methods
Reproducibility of Results
Review
Risk factors
Sepsis
Technology application
Ventilators
Spain
Host response
Digital PCR
Prognosis and treatment guidance
Infection diagnosis
Critically ill patients
ISSN:1364-8535, 1466-609X, 1364-8535, 1466-609X, 1366-609X
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Shrnutí:Infection (either community acquired or nosocomial) is a major cause of morbidity and mortality in critical care medicine. Sepsis is present in up to 30% of all ICU patients. A large fraction of sepsis cases is driven by severe community acquired pneumonia (sCAP), which incidence has dramatically increased during COVID-19 pandemics. A frequent complication of ICU patients is ventilator associated pneumonia (VAP), which affects 10–25% of all ventilated patients, and bloodstream infections (BSIs), affecting about 10% of patients. Management of these severe infections poses several challenges, including early diagnosis, severity stratification, prognosis assessment or treatment guidance. Digital PCR (dPCR) is a next-generation PCR method that offers a number of technical advantages to face these challenges: it is less affected than real time PCR by the presence of PCR inhibitors leading to higher sensitivity. In addition, dPCR offers high reproducibility, and provides absolute quantification without the need for a standard curve. In this article we reviewed the existing evidence on the applications of dPCR to the management of infection in critical care medicine. We included thirty-two articles involving critically ill patients. Twenty-three articles focused on the amplification of microbial genes: (1) four articles approached bacterial identification in blood or plasma; (2) one article used dPCR for fungal identification in blood; (3) another article focused on bacterial and fungal identification in other clinical samples; (4) three articles used dPCR for viral identification; (5) twelve articles quantified microbial burden by dPCR to assess severity, prognosis and treatment guidance; (6) two articles used dPCR to determine microbial ecology in ICU patients. The remaining nine articles used dPCR to profile host responses to infection, two of them for severity stratification in sepsis, four focused to improve diagnosis of this disease, one for detecting sCAP, one for detecting VAP, and finally one aimed to predict progression of COVID-19. This review evidences the potential of dPCR as a useful tool that could contribute to improve the detection and clinical management of infection in critical care medicine.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ObjectType-Review-3
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ISSN:1364-8535
1466-609X
1364-8535
1466-609X
1366-609X
DOI:10.1186/s13054-022-03948-8