Introduction: Direct pathogen detection technologies, such as multiplexed PCR 1-5 or the CANARY system 6, are important in military Indeterminates (n=53) were excluded. A blood sample was drawn for SeptiCyte RAPID within the first day of admission. SeptiCyte RAPID reports a likelihood of sepsis on a scale of 0-15 (SeptiScore) falling into four bands and is available on a near-patient platform. Blood cultures were collected if they were deemed clinically necessary. Results: From 205 BC+ sepsis patients, 84 were Gram+, 107 were Gram- & 14 were mixed (both Gram+ & Gram-). The ROC-AUC for differentiating all BC+ sepsis vs. SIRS (n=356) was 0.90, for Gram+ 0.88, for Gram- 0.92, for mixed (Gram+ & Gram-) 0.87, & for Gram+ (S.aureus only) 0.88. For multi-drug resistant ESKAPE pathogens (n=54) (E. faecium, S. aureus, K. pneumoniae, A. baumannii, P. aeruginosa, Enterobacter spps.) 9, AUC was 0.91. Conclusions: SeptiScore correlated to likelihood of blood culture positivity regardless of Gram-status. Most BC+ sepsis patients had high SeptiScores (93.7% in Bands 3/4) including those positive for ESKAPE pathogens. These results, in combination with a short TaT and using near-patient technology, suggest that SeptiCyte RAPID can be used to guide blood culture practice such as implementing blood culture orders for patients presenting with high SeptiScores if not originally drawn.
Davis et al. (Sun,) studied this question.