Kenan İSTANBULLU, Nilgün KÖKSAL, Merih ÇETİNKAYA, Hilal ÖZKAN, Tahsin YAKUT, Mutlu KARKUCAK, Haldun DOĞAN

The potential utility of real-time PCR of the 16S-rRNA gene in the diagnosis of neonatal sepsis

The purpose of this study was to evaluate the efficacy of real-time polymerasechain reaction (PCR) of the 16S rRNA gene in diagnosis of neonatal sepsisand compare it with conventional blood culture.A total of 150 infants were enrolled in this prospective study. The infants wereclassified into two groups: sepsis group (n=100) and control group (n=50).Blood samples for complete blood count, C-reactive protein, procalcitonin,serum-amyloid A, blood culture and PCR were obtained before initiatingantibiotic treatment. Eight specific probes were used to perform PCR analysisfor detection of 8 different microorganisms.The positivity rates of blood culture and PCR were found as 11% and 3%,respectively. The diagnosis of neonatal sepsis by PCR revealed a 16.6 %sensitivity, 97.8 % specificity, 33.3% positive predictive value and 94.8%negative predictive value compared with the blood culture.This study showed a low sensitivity of PCR of the 16S rRNA gene in thediagnosis of neonatal sepsis. This may be associated with the identificationof rare microorganisms in the blood culture that were not included to PCRanalysis. Implementation of all suspectible microorganisms into PCR assaymay increase the sensitivity of 16S rRNA gene PCR in diagnosis of neonatalsepsis.

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