Application of broad-range bacterial PCR amplification and direct sequencing on the diagnosis of neonatal sepsis

A broad-range bacterial PCR target to conserved regions of the 23S rDNA was applied to 306 blood culture samples from 295 infants (up to one year of age) admitted to a neonatal intensive care unit. Classic blood culture results were compared to DNA sequencing analysis of the PCR amplification products. Culture results were in agreement to DNA sequencing in 90.5% (277) of 306 samples tested, including 263 PCR and culture negative samples and 29 culture and PCR positive samples. The sensitivity of the PCR method combined with sequencing was 88%, and the specificity was 96.3%, with positive and negative predictive values of 74.3 e 98.5%, respectively. The PCR-based approach directly applied to blood culture samples, correlated well with blood culture results from neonates with presumptive diagnosis of bacterial sepsis. The PCR/sequencing approach is suggested to be a valuable complementary data for diagnosis of neonatal sepsis. This methodology is relatively easy and reliable giving accurate results that can be applied to samples colleted during antimicrobial treatment or by a hospital clinical procedure, especially when routine cultures are negative. It can also be useful for the identification of rare bacterial species and for those isolates not readily identified by microbiological tests