PCR and blood culture of Escherichia coli bacteremia in rats

Klinik für Anästhesiologie, Hygiene Institute, University of Tübingen, Tübingen, Germany.
Journal of Clinical Microbiology (Impact Factor: 4.23). 08/1999; 37(8):2479-82.
Source: PubMed

ABSTRACT Critically ill patients often develop symptoms of sepsis and therefore require microbiological tests for bacteremia that use conventional blood culture (BC) techniques. However, since these patients frequently receive early empirical antibiotic therapy before diagnostic procedures are completed, examination by BC can return false-negative results. We therefore hypothesized that PCR could improve the rate of detection of microbial pathogens over that of BC. To test this hypothesis, male Wistar rats were challenged intravenously with 10(6) CFU of Escherichia coli. Blood was then taken at several time points for detection of E. coli by BC and by PCR with E. coli-specific primers derived from the uidA gene, encoding beta-glucuronidase. In further experiments, cefotaxime (100 or 50 mg/kg of body weight) was administered intravenously to rats 10 min after E. coli challenge. Without this chemotherapy, the E. coli detection rate decreased at 15 min and at 210 min after challenge from 100% to 62% of the animals with PCR and from 100% to 54% of the animals with BC (P, >0.05). Chemotherapy decreased the E. coli detection rate at 25 min and at 55 min after challenge from 100% to 50% with PCR and from 100% to 0% with BC (P, <0.05). Thus, at clinically relevant serum antibiotic levels, PCR affords a significantly higher detection rate than BC in this rat model. The results suggest that PCR could be a useful adjunct tool supplementing conventional BC techniques in diagnosing bacteremia.

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    • "Once diluted, one loop was cultured on MacConkey agar (direct plating) at 37 8C for 18–20 h. One compatible colony per plate was selected and confirmed by PCR (Heininger et al., 1999). This confirmed colony of indicator E. coli (i.e. one clon per animal) was tested for antimicrobial susceptibility. "
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    • "Hackett even showed a concentration peak in severe cases of septicaemia to a maximum of 1.8 × 10 9 bacteria per mL [24] [25] [26]. Heininger et al. (1999) demonstrated the advantage of PCR detection of preceding antibiotic treatment in a rat model. Whereas the detection rate of classical blood cultures falls to 10 % within 25 min after intravenous administration of cefotaxime, the PCR detection rate is still 100% at that time [27]. "
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