Multiplex droplet digital polymerase chain reaction for rapid diagnosing suspected bloodstream infections in patients with hematologic malignancies

作者：Fangyi Dong, Shishuang Wu, Xiaoqiang Fan, Ge Jiang, Ran Li, Liping Zhu, Jing Wang, Jiang Xia, Yu Zheng, Junmin Li, Kai Qing, Kai Xue · 发表于：Translational Cancer Research · 年份：2026 · DOI：10.21037/tcr-23-2240 · 研究领域：Innovative Microfluidic and Catalytic Techniques Innovation、Bacterial Identification and Susceptibility Testing、Biosensors and Analytical Detection

Background: Patients with acute leukemia are at increased risk of microbial infections due to factors such as the disease itself, intensive chemotherapy, and transplantation. Untimely or inadequate treatment can prolong therapy, raise costs, and even threaten patient survival, impacting overall cancer treatment outcomes. Traditional microbial identification relies on blood cultures (BCs), but their low positivity rate and lengthy processing time often hinder prompt diagnosis and the identification of the infecting pathogens. This study aimed to use droplet digital polymerase chain reaction (ddPCR), known for its sensitivity in single-molecule amplification, to detect pathogen DNA and drug-resistant genes in blood. Methods: We included a total of 47 patients with hematologic malignancies who were over 18 years old and had neutropenia accompanied by fever [suspected bloodstream infection (BSI)] from August 2022 to November 2022. Patients who failed resuscitation after severe shock, with severe liver or kidney dysfunction, and in the terminal stage were excluded. We conducted ddPCR testing for bacteria/fungi/viruses with the patient’s blood on the first day, third day, and fifth day of the occurrences of neutropenic fever with suspected BSI. In case of positive results indicating the presence of bacteria, we used the remaining nucleic acid samples to detect drug resistance genes. Results: BC and ddPCR yielded positive results indicating the presence of bacteria in five patients ...