A Multiplex PCR assay for Detection of Vibrio vulnificus, Aeromonas hydrophila, Methicillin-resistant Staphylococcus aureus, Streptococcus pyogenes, and Streptococcus agalactiae from the Isolates of Patients with Necrotizing Fasciitis.

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A Multiplex PCR assay for Detection of Vibrio vulnificus, Aeromonas hydrophila, Methicillin-resistant Staphylococcus aureus, Streptococcus pyogenes, and Streptococcus agalactiae from the Isolates of Patients with Necrotizing Fasciitis.

Int J Infect Dis. 2019 Jan 25;:

Authors: Tsai YH, Chen PH, Yu PA, Chen CL, Kuo LT, Huang KC

Abstract
BACKGROUND: Vibrio vulnificus, Aeromonas hydrophila, methicillin-resistent Staphylococcus aureus (MRSA), Group A Streptococcus, and Group B Streptococcus, are commonly detected causative agents of necrotizing fasciitis (NF) in our institution. This study aimed to develop and evaluate a multiplex PCR method for the simultaneous detection of five of the most important human pathogens involved in NF by using a novel combination of species-specific genes.
METHODS: Samples used here were collected from 99 patients with surgically confirmed necrotizing fasciitis of the extremities that were consecurtively hospitalized between June 2015 and November 2017. Two sets of blood and tissue samples were collected from all patients; one set was sent to a microbiologic laboratory for bacterial identification, and the other set was sent to an immunohistochemical laboratory for PCR amplification.
RESULTS: The multiplex PCR results of the blood samples showed negative finding. The multiplex PCR results of tissue specimens showed 28 positive findings. Fourteen (87.5%) of the 16 Vibrio vulnificus culture-positive tissue specimens, 6 (75%) of the 8 Aeromonas hydrophila culture-positive tissue specimens, and 4 (100%) of the 4 MRSA culture-positive tissue specimens presented PCR positive results. Similarly, 2 (100%) of the Group A Streptococcus and 2 (100%) of Group B Streptococcus showed PCR positive.
CONCLUSIONS: The accuracy rate of the multiplex PCR presenting positive results in these culture-positive tissue samples was 87.5% (28/32). These findings suggest that the multiplex PCR of tissue specimens may be an useful and rapid diagnostic tool for detection of these lethal microorganisms in patients with necrotizing fasciitis.

PMID: 30690211 [PubMed - as supplied by publisher]