Enhanced detection of sepsis pathogens in hospitalized febrile neutropenia patients using blood culture broths with TaqMan array card.

BACKGROUND

In resource-limited settings, febrile neutropenia (FN) is one of the common cause of morbidity and mortality among immunocompromised individuals particularly those undergoing chemotherapy for malignancies. The clinical diagnosis and management of disease is challenging, due to the diverse range of causative pathogens and overreliance on the traditional diagnostic techniques. TaqMan array card (TAC), a microfluidics-based technique that allows simultaneous and rapid detection of multiple pathogens with high sensitivity, addressing these diagnostic needs.

OBJECTIVE

The aim of this study was to determine the role of TAC in improving pathogen identification in hospitalized patients with FN.

METHODS

This cross-sectional study enrolled 156 FN patients admitted to Aga Khan University and Hospital, Karachi, Pakistan. To enhance pathogen detection, blood culture broths were used for microbial enrichment, improving sensitivity and reliability. Both blood cultures and TAC assays were performed on the collected broths. Enrichment strategies were employed to reduce the impact of PCR inhibitors and increase microbial biomass, thereby enhancing the diagnostic sensitivity of TAC.

RESULTS

TAC identified a diverse range of pathogens compared with traditional blood culture. Of 156 study participants, 61 (39.1 %) were culture-positive and at least one pathogen was detected in 50 of the 146 samples by TAC assay. The common pathogen detected by TAC was K. pneumonia followed by E. coli and S. aureus, and Candida species along with two viruses (Parvovirus B19 and HHV6). Kappa values of 0.319 for E. coli and 0.644 for K. pneumoniae, TAC demonstrated a moderate association with blood culture results. Moreover, K. pneumoniae, E. coli, and P. aeruginosa and Candida species were significantly associated with increased mortality among FN patients.

CONCLUSION

The findings of this study suggest that TAC improves pathogen detection with high sensitivity in FN patients. Incorporating TAC into clinical settings may facilitate early pathogen identification leading to better clinical outcomes. Multicenter studies are needed to validate these results and assess the effectiveness of TAC in broader clinical settings.