Archive for August 1, 2018

Vancomycin Prophylaxis for Total Joint Arthroplasty: Incorrectly Dosed and Has a Higher Rate of Periprosthetic Infection Than Cefazolin.

Clin Orthop Relat Res. 2017 Jul;475(7):1775-1778.

Soriano A1.

Author information

1 Service of Infectious Diseases, IDIBAPS, Hospital Clinic Universitari, University of Barcelona, C/ Villarroel 170, Barcelona, Catalonia, 08036, Spain.


August 1, 2018 at 8:17 am

Rapid Diagnosis of Staphylococcal Catheter-Related Bacteraemia in Direct Blood Samples by Real-Time PCR.

PLoS One. 2016 Aug 29;11(8):e0161684.

Zboromyrska Y1, De la Calle C2, Soto M3, Sampietro-Colom L3, Soriano A2, Alvarez-Martínez MJ1, Almela M1, Marco F1,4, Arjona R1, Cobos-Trigueros N2, Morata L2, Mensa J2, Martínez JA2, Mira A5, Vila J1,4.

Author information

1 Department of Clinical Microbiology, Biomedical Diagnostic Centre (CDB), Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain.

2 Department of Infectious Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain.

3 Health Technology Assessment Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain.

4 ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, University of Barcelona, Barcelona, Spain.

5 CDB, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain.


Catheter-related bacteremia (CRB) is an important cause of morbidity and mortality among hospitalized patients, being staphylococci the main etiologic agents. The objective of this study was to assess the use of a PCR-based assay for detection of staphylococci directly from blood obtained through the catheter to diagnose CRB caused by these microorganisms and to perform a cost-effectiveness analysis. A total of 92 patients with suspected CRB were included in the study. Samples were obtained through the catheter. Paired blood cultures were processed by standard culture methods and 4 ml blood samples were processed by GeneXpert-MRSA assay for the detection of methicillin-susceptible (MSSA) or methicillin-resistant (MRSA) Staphylococcus aureus, and methicillin-resistant coagulase-negative staphylococci (MR-CoNS). Sixteen CRB caused by staphylococci were diagnosed among 92 suspected patients. GeneXpert detected 14 out of 16 cases (87.5%), including 4 MSSA and 10 MR-CoNS in approximately 1 hour after specimen receipt. The sensitivity and specificity of GeneXpert were 87.5% (CI 95%: 60.4-97.8) and 92.1% (CI 95%: 83-96.7), respectively, compared with standard culture methods. The sensitivity of GeneXpert for S. aureus was 100%. Regarding a cost-effectiveness analysis, the incremental cost of using GeneXpert was of 31.1€ per patient while the incremental cost-effectiveness ratio of GeneXpert compared with blood culture alones was about 180€ per life year gained. In conclusion, GeneXpert can be used directly with blood samples obtained through infected catheters to detect S. aureus and MR-CoNS in approximately 1h after sampling. In addition, it is cost-effective especially in areas with high prevalence of staphylococcal CRB.


August 1, 2018 at 8:16 am


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