Utility of Multiplex PCR in Detecting the Causative Pathogens for Pediatric Febrile Neutropenia

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Febrile neutropenia (FN) is a life-threatening complication, and the primary causeof FN is considered to be microbial infection. Therefore, prompt and appropriateantimicrobial therapy is crucial. Clinicians usually prescribe antimicrobial therapy onthe basis of presumptive and empirical data. This is because the causative pathogen forFN in blood culture (BC) analysis is detected several days after sampling. Polymerasechain reaction (PCR) analysis has been used for detecting the causative bacteria ofinfections. Here, we examined whether multiplex PCR is useful for detecting thecausative pathogens for FN patients.We extracted DNA from the patients' whole blood and performed multiplex PCR.In total, 128 samples of 40 patients clinically diagnosed with FN were used in this study.Multiplex PCR analysis revealed the causative pathogen in 3 patients with FN; theDNA fragments amplified were those of Pseudomonas aeruginosa in 2 cases andPsedomonas putida in 1 case. These patients could be started on appropriateantimicrobial therapy a few hours after sampling. However, the DNA fragment of thecausative pathogen could not be amplified by PCR in 2 patients, although BC analysisdid detect the causative bacteria.Thus, we conclude that multiplex PCR is serviceable in case of FN because of itsrapidness. However, BC is also indispensable to treating FN owing to its highsensitivity.
2011-00-00