rRNA gene Sanger sequencing is being used for the identification of cultured pathogens. A new diagnostic approach is sequencing of uncultured samples by using the commercial DNA extraction and sequencing platform SepsiTest (ST). The goal was to analyze the clinical performance of ST with a focus on nongrowing pathogens and the impact on antibiotic therapy. A literature search used PubMed/Medline, Cochrane, Science Direct, and Google Scholar. Eligibility followed PRISMA-P criteria. Quality and risk of bias were assessed drawing on QUADAS-2 (quality assessment of diagnostic accuracy studies, revised) criteria. Meta-analyses were performed regarding accuracy metrics compared to standard references and the added value of ST in terms of extra found pathogens. We identified 25 studies on sepsis, infectious endocarditis, bacterial meningitis, joint infections, pyomyositis, and various diseases from routine diagnosis. Patients with suspected infections of purportedly sterile body sites originated from various hospital wards. The overall sensitivity (79%; 95% confidence interval [CI], 73 to 84%) and specificity (83%; 95% CI, 72 to 90%) were accompanied by large effect sizes. ST-related positivity was 32% (95% CI, 30 to 34%), which was significantly higher than the culture positivity (20%; 95% CI, 18 to 22%). The overall added value of ST was 14% (95% CI, 10 to 20%) for all samples. With 130 relevant taxa, ST uncovered high microbial richness. Four studies demonstrated changes of antibiotic treatment at 12% (95% CI, 9 to 15%) of all patients upon availability of ST results. ST appears to be an approach for the diagnosis of nongrowing pathogens. The potential clinical role of this agnostic molecular diagnostic tool is discussed regarding changes of antibiotic treatment in cases where culture stays negative.

• Klíčová slova
• added value of sequencing, agnostic molecular diagnosis, bacterial meningitis, change of antibiotic treatment, culture-negative infections, fastidious and rare pathogens, infectious endocarditis, joint infections, nongrowing pathogens, sepsis,
• MeSH
• antibakteriální látky MeSH
• Bacteria * genetika   MeSH
• geny rRNA MeSH
• lidé MeSH
• mykózy * MeSH
• polymerázová řetězová reakce metody   MeSH
• RNA ribozomální 16S genetika   MeSH
• RNA ribozomální 18S MeSH
• senzitivita a specificita MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH
• systematický přehled MeSH
• Názvy látek
• antibakteriální látky MeSH
• RNA ribozomální 16S MeSH
• RNA ribozomální 18S MeSH

In the microbiological diagnosis of bloodstream infections (BSI), blood culture (BC) is considered the gold standard test despite its limitations such as low sensitivity and slow turnaround time. A new FDA-cleared and CE-marked platform utilizing magnetic resonance to detect amplified DNA of the six most common and/or problematic BSI pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Escherichia coli; referred to as ESKAPEc) is available and may shorten the time to diagnosis and potentially improve antimicrobial utilization. Whole blood samples from hospitalized patients with clinical signs of sepsis were analyzed using the T2Bacteria Panel (T2Biosystems) and compared to simultaneously collected BC. Discrepant results were evaluated based on clinical infection criteria, combining supporting culture results and the opinion of treating physicians. A total of 55 samples from 53 patients were evaluated. The sensitivity and specificity of the T2Bacteria panel was 94% (16 out of 17 detections of T2Bacteria-targeted organisms) and 100%, respectively, with 36.4% (8 of 22) causes of BSI detected only by this method. The T2Bacteria Panel detected pathogens on average 55 hours faster than standard BC. In our study, 9 of 15 patients with positive T2Bacteria Panel results received early-targeted antibiotic therapy and/or modification of antimicrobial treatment based on T2Bacteria Panel findings. Given the high reliability, faster time to detection, and easy workflow, the technique qualifies as a point-of-care testing approach.

• Klíčová slova
• T2MR, antimicrobial stewardship, bacteremia, blood culture, rapid diagnostics, sepsis,
• MeSH
• Acinetobacter baumannii účinky léků   genetika   izolace a purifikace   MeSH
• antibakteriální látky farmakologie   MeSH
• antibiotická politika metody   MeSH
• bakteriemie krev   farmakoterapie   mikrobiologie   MeSH
• Enterococcus faecium účinky léků   genetika   izolace a purifikace   MeSH
• Escherichia coli účinky léků   genetika   izolace a purifikace   MeSH
• Klebsiella pneumoniae účinky léků   genetika   izolace a purifikace   MeSH
• krev mikrobiologie   MeSH
• kultivační vyšetření krve MeSH
• lidé MeSH
• prospektivní studie MeSH
• Pseudomonas aeruginosa účinky léků   genetika   izolace a purifikace   MeSH
• Staphylococcus aureus účinky léků   genetika   izolace a purifikace   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antibakteriální látky MeSH