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Table 2 Positive blood cultures and SeptiFast results, physicians’ judgement, clinical findings and the resulting changes in antimicrobial therapy

From: Prospective evaluation of SeptiFast Multiplex PCR in children with systemic inflammatory response syndrome under antibiotic treatment

  BC SeptiFast Judgement Significant clinical information Lab findings Other specimen Change of therapy
1   Stenotrophomonas maltophilia,
Streptococcus pneumoniae
Infection with stenotro-phomonas Neuropediatric, PICU, MV, VP PCT 32.13 ng/ml
CRP 6.8 mg/dl
WBC 3.43/nl
Throat swab: Streptococcus pneumoniae (colonisation) SF: Additionally cotrimoxazole
2   Pseudomonas aeruginosa Infection After liver tx PCT 1.87 ng/ml
CRP 14.1 mg/dl
WBC 1.05/nl
  No (under therapy with piperacillin/ tazobactam, fosfomycin)
3   Enterobacter cloacae Infection BPD, PICU, MV, VP, 38.7 °C PCT not done
CRP 2.3 mg/dl
WBC 3.43/nl
Tracheal aspirate: Enterobacter cloacae No (under cefotaxime)
9 CONS Enterobacter cloacae Co-infection Neuropediatric, PICU, MV, 40.5 °C PCT 0.53 ng/ml
CRP 0.5 mg/dl
WBC 24.13/nl
  SF: Meropenem instead of cefotaxime
BC: Additionally vancomycin
13   Pseudomonas aeruginosa Not assessable ALL relapse, 38.8 °C PCT not done
CRP 11.3 mg/dl
WBC 0.19/nl
15   Klebsiella pneumoniae Infection After bone marrow tx, 38.6 °C PCT not done
CRP 19.5 mg/dl
WBC 10.2/nl
  SF: Additionally ciprofloxacin
18 CONS CONS, Candida albicans Co-infection Neuropediatric, PICU, 39.4 °C PCT 0.59 ng/ml
CRP 2 mg/dl
WBC 7.8/nl
Second BC: CONS SF: Additionally fluconazole
19   Klebsiella pneumoniae Infection After liver tx, PICU, MV, VP, 34 °C PCT 8.04 ng/ml
CRP 8.5 mg/dl
WBC 14.62/nl
  No (under Piperacillin/tazobactam)
20   Escherichia coli Infection After liver tx, recurring cholangitis PCT 1.21 ng/ml
CRP 10.2 mg/dl
WBC 15.05/nl
  No (under ciprofloxacin)
26   Streptococcus spp. Infection ALL, PICU, MV, 38.8 °C PCT 22.52 ng/ml
CRP 39.8 mg/dl
WBC 0.04/nl
BC 2 days before study: Streptococcus spp. No (under meropenem)
32 Candida albicans Enterococcus faecalis, fungi PCR n/a Co-infection Non-Hodgkin-lymphoma, PICU, 38.6 °C PCT 0.97 ng/ml
CRP 6.6 mg/dl
WBC 0.1/nl
  BC: New CVC; additionally caspofungin,
SF: linezolid instead of vancomycin
37   Candida albicans Infection ALL, 39.2 °C PCT 1.1 ng/ml
CRP 18.8 mg/dl
WBC 0.95/nl
Throat swab: Candida albicans (colonisation) No (liposomal amphotericin B was started before SF result)
38   Pseudomonas aeruginosa Infection After kidney tx, PICU, MV, VP PCT 72.01 ng/ml
CRP 6.4 mg/dl
WBC 7.61/nl
Tracheal aspirate, ascites: Pseudomonas aeruginosa SF: Meropenem instead of cefazoline
39 Klebsiella pneumoniae Klebsiella pneumoniae, Streptococcus spp. Infection with Klebsiella After liver tx, short bowel syndrome PCT 14.56 ng/ml, CRP14 mg/dl
WBC 1.56/nl
Bile: Klebsiella pneumoniae BC+ SF:
Discontinuation of vancomycin
  1. BC blood culture, SF SeptiFast, MV mechanical ventilation, VP vasopressor, PICU Pediatric Intensive Care Unit, tx transplantation, BPD bronchopulmonary dysplasia, CONS coagulase negative staphylococci, ALL acute lymphoblastic leukemia, Stenotroph Stenotrophomonas, spp. species, Klebs. pneum Klebsiella pneumoniae, CRP C-reactive protein, PCT procalcitonin, WBC white blood count, n/a not assessable