Although the antibiotics used prevented the growth of organisms in blood culture analysis, it appeared that DNA Detection Kit could detect pathogens with relatively little interference http://www.selleckchem.com/products/chir-99021-ct99021-hcl.html by antibiotics. Our results are in agreement with the information provided by the SeptiFast manufacturer that antibiotics do not interfere with SeptiFast detection of pathogens [6]. These data suggest that SeptiFast will have clinical utility for analysis of pathogens in patients with a background of unknown pre-treatment of antibiotics due to being referred from other hospitals, and for patients receiving antibiotics before blood collection for testing due to the severity of their condition. Another clinical benefit of SeptiFast is that the test result is achieved faster than the result of blood culture analysis, and thus will allow a speedier de-escalation from a broad- to a narrow-spectrum antibiotic.

According to the “Surviving Sepsis Campaign Guidelines (SSCG) 2008″, antibiotic administration within an hour is recommended in patients suspected of having severe sepsis [20]. Therefore, the use of the DNA Detection Kit, whose pathogen detection ability is not susceptible to the effects of antibiotic administration, should contribute to implementation of these guidelines.Table 4Comparison of pathogen detection by SeptiFast and blood culture analyses following treatment with the antibiotic appropriate to the pathogenIn Japan, blood culture analysis is the gold standard of pathogen analysis when sepsis is suspected.

However, it is anticipated that if SeptiFast analysis is introduced, it will facilitate the selection of antibiotics based on EBM due to earlier pathogen detection and to the detection of more pathogens. DNA Detection Kit analysis cannot replace blood culture analysis because it cannot detect all sepsis pathogens. However, by combining SeptiFast and blood culture analyses, the detection rate of pathogens will significantly increase. A faster detection rate will be especially useful for SIRS patients since more precise sepsis treatment will become feasible. Since the use of the DNA Detection Kit requires skilled clinical laboratory technicians and suitable facilities, the kit should be used in university hospitals where severe sepsis patients are gathered.The extended duration of surgical antibiotic prophylaxis for up to seven days and multicoverage for empiric therapy of suspected sepsis is performed in Japan.

Thus, our results are not easily applicable to other regions since the diagnostic value of conventional blood culture systems in this study may have been decreased by very frequent previous antibiotic exposure.ConclusionsAlthough DNA Detection Cilengitide Kit analysis could not detect all sepsis pathogens, SeptiFast analysis did detect potentially important pathogenic DNA that could not be detected by blood culture analysis.