CVVH was well tolerated by all patients. The blood cultures of 2 of 9 (22%) patients were positive. However, bacterial DNA was identified in the blood of 6 patients (67%; p = 0.06), including the 2 septic patients with positive blood cultures. In 9 (100%; p = 0.01) patients bacterial DNA was found on the filter blood side, whereas in 7 (78%; p = 0.03) subjects bacterial DNA was found in the dialysate compartment of the hemofilters. Bacterial DNA was never detected in the UF.

Usefulness of a Molecular Strategy for the Blood Purif 2007;25:106-111 109

Detection of Bacterial DNA

Detailed results are given in table 2. Briefly, in a positive blood culture patient with catheter-related sepsis from Staphylococcus aureus (subject 2), multiple species of bacterial DNA were found in the blood and trapped in the filter, and reported as 'non-sequentiable'. Pseudomonas DNA was found in the blood and filter of another positive control patient (subject 3A), which matched the organism yielded from blood culture. Of interest, after 3 weeks of appropriate therapy in this patient (subject 3B), when the organism could not be detected by blood culture and bacterial DNA in blood, bacterial DNA still remained and was trapped in the blood compartment of the hemofilter. Even though repeated blood cultures of subjects 4-9 had been negative, bacterial DNA was recovered from hemofilters used in CRRT by bacterial 16S rRNA gene sequence analysis. Bacterial DNA was identified only in the blood of subjects 4 and 7-9, but not in subjects 5 and 6. However, this diagnostic method yielded a single organism in 2 patients (subjects 8 and 9), and multiple organisms in other patients (reported as non-sequenti-able).

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