Non-culture based diagnostic tests for detection of bacterial infections in hematology patients with febrile neutropenia: A review by the European Conference on Infections in Leukemia (ECIL-10)
Current Research in Translational Medicine, cilt.74, sa.3, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Derleme
- Cilt numarası: 74 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.retram.2026.103600
- Dergi Adı: Current Research in Translational Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Anahtar Kelimeler: Diagnostics, Febrile neutropenia, Hematologic malignancy, Multiplex pcr, Next generation sequencing
- Hacettepe Üniversitesi Adresli: Evet
Özet
Background Limited data are available on the performance of non-culture-based diagnostics in hematology patients with febrile neutropenia (FN). Methods The European Conference on Infections in Leukaemia (ECIL) 10 group performed a review (2011–2024) on the performance of available in Europe non-culture-based diagnostic methods on blood samples in hematology patients with FN, focusing on bacterial infections. The following tests were included: direct matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS), multiplex/specific polymerase chain reaction (PCR), T2-magnetic resonance (T2MR), and metagenomic next generation sequencing (mNGS). A list of 6 predefined pertinent questions was assessed for the performance of each test. Results For MALDI-TOF-MS, 4/16 (25%) articles were retained, including 475 hematology patients (98 with FN), with sensitivity ranging from 63 to 92.6%. For multiplex-PCR, 8/293 (2.7%) articles were retained, including 509 hematology patients (209 with FN), with a sensitivity of 80.5% and 100% (2 studies) and one study reporting a specificity of 88.5%. For T2MR, 1/18 (5.6%) article was retained including 648 hematology patients (309 with FN) and sensitivity and specificity of 84.2 and 85.9%, respectively. For mNGS, 6/35 (17%) articles were retained: 459 hematology patients (335 with FN), sensitivity (40–100%) and specificity (40–84%) reported in 3 studies. No articles were found on specific PCR in hematology patients. Improved microbiological documentation was reported in 5, 1, and 5 studies on multiplex-PCR, T2MR, and mNGS, respectively. Faster time to diagnosis was reported in 1, 5, and 1 studies on MALDI-TOF-MS, multiplex-PCR, and T2MR, respectively. Treatment choice was affected by the results of MALDI-TOF-MS, multiplex-PCR, mNGS in 1, 6, and 2 studies, respectively. No significant impact on overall survival or length of stay was reported for any of the tests reviewed. Conclusions Limited evidence exists on the performance of non-culture-based diagnostics in hematology patients. Blood cultures should be routinely used, even if new tests are available, which should be used in conjunction with the routine microbiological techniques, until more quality data are available.