PCR Testing – Ipsum Diagnostics

PCR TESTING

WHAT IS PCR?

PCR, short for Polymerase Chain Reaction, is a lab technique that quickly identifies infection causing organisms. Small quantities of DNA or RNA in a sample are amplified, (that is increased in number) and detected using a targeted approach for finding the pathogens (fungal, bacterial or viral).

Ipsum Diagnostic’s PCR technique more accurately and rapidly identifies potential pathogenic organisms and resistant genes than conventional culture methods. It is amazing to think that we can now identify the infection with greater sensitivity and specificity and the medication that will stop it in its tracks!

WHAT WE TEST

Onychomycosis & Other Infections

Nails: Onychomycosis caused by dermatophytes, Candida and molds and bacteria such as Pseudomonas. Findings can be correlated with histology if requested.

Scalp: Tinea capitis – is especially beneficial in the pediatric population. Our swab prevents the need for hair plucking or a biopsy.

Skin: Tests for both bacterial and fungal pathogens and antibiotic resistant genes using a single swab.

Aspirate: Fine Needle Aspiration FNA to evaluate for pathogens

Wound: Testing for both bacterial and fungal pathogens using a single swab

Urine: Tests for common gram negative infections such as E. coli, Klebsiella, Proteus and Enterobacter as well as gram positive and fungal organisms.

Bone: Test for osteomyelitis

DERMATOLOGIC POLYMERASE CHAIN REACTION (PCR)

Why wait days for a bacterial panel and weeks for fungal culture results?

Ipsum Diagnostics can get your test results to you in less than 24 hours.

Real-time PCR utilizes highly specific assays for rapid, accurate profiling of polymicrobial infections. Let Ipsum provide your practice with quicker turn-around time for more effective treatment and superior patient care.

The advantages of PCR over traditional culture is unambiguous results that assist you with making all-important treatment decisions:

Faster, more accurate and precise results
Increased sensitivity and less prone to cross-contamination
Rapid results help minimize morbidity and reduce costs
DNA is extracted even on your most fragile specimens regardless of the viability of the swab

Ipsum’s proprietary ePrecision© process ensures reliable results backed by science. Our DNA extraction techniques provide testing for multiple pathogens types (bacterial and fungal) on a single swab.

In addition, Ipsum offers our providers Comprehensive Consultation Services by Infectious Disease Specialists to review test results for clinical significance. Ipsum offers “Smart Report Results” with clinical data like:

Presence of pathogenic organisms and sensitivities
Targeted medications
Medication allergies
Health conditions, age and more
Streamlined Results using a Single Report
Multiple panels (bacterial and fungal) can be provided on a customizable single report
Delivering integrated enhanced reporting
Full clinical picture all in one place
Simplifies the clinical decision process making it more efficient for you and your staff to provide your patients timely treatment

COMING SOON: Viral, mycobacterial and Deep Fungal Panels

URINARY TRACT INFECTIONS

UTI was once a simple-to-treat infection which has become more challenging to treat over the last 25 years. (1) Half of the population can expect to get a UTI at least once in their lifetime. This common community or hospital-acquire infection accounts for considerable morbidity and health-care expenditure with an estimated annual cost of US$3.5 billion in USA.

The majority of UTIs are caused by Gram-negative pathogens, primarily from the Enterobacteriaceae family including E. coli, Proteus, Klebsiella, and Enterobacter species. Gram positive and fungal organisms also cause UTI in certain populations, such as patients with indwelling catheters, diabetes, or recent antibiotic use. Multidrug-resistant organisms (MDROs) are becoming more common due to antibiotic overuse. MDROs limit empiric treatment failures, Untreated UTI can lead to pyelonephritis, bacteremia and sepsis.

UTI: MOLECULAR ASSESSMENT

PCR Testing for Bacteria, Fungi and Antibiotic Resistant Genes

Quinolone and fluoroquinolone Resistance:
QnrA
QnrB

Vancomycin Resistance:
vanA1
vanBF
vanC1

Carbapenem Resistance:
VIM
KPC
IMP-2 group
OXA-48

Macrolide Resistance:
ErmA
ErmB
ErmC

Methicillin Resistance:
MecA

Extended-Spectrum-Betalactamase:
SHV
CTX-M group 1

Fungi
Yeast
Candida albicans
Candida glabrata
Candida parapsilosis
Candida tropicalis
Candida aureus

Bacteria
Gram Negative
Acinetobacter baumannii
Providencia stuartii
Pseudomonas aeruginosa
Citrobacter freundii
Enterobacter aerogenes
Enterobacter cloacae
Escherichia coli
Klebsiella pneumoniae
Morganella morganii
Proteus mirabilis
Proteus vulgaris
Klebsiella oxytoca

Gram Positive
Enterococcus faecalis
Enterococcus faecium
Staphylococcus aureus
Staphylococcus epidermidis
Staphylococcus saprophyticus
Streptococcus agalactiae
(Group B)
Streptococcus pyogenes
Streptococcus pneumoniae

Anaerobic
Clostridium Perfringens
Peptostreptococcus anaerobius
Bacteroides fragilis
Fingoldia magna
(Peptostreptococcus magnus)

PCR VS TRADITIONAL WOUND CULTURE

PCR is superior to traditional wound culture because it is faster (results within 24 hours vs days to weeks), more sensitive and less prone to cross contamination. Testing for both bacterial and fungal pathogens is done with a single swab.

PCR VS URINE
DIPSTICK

Urine dipsticks are quick and easy for point-of-care testing but do not provide microbiological diagnosis. Urine dipsticks can give false-negative results with non-nitrite producing pathogens such as Enterococcus and Staphylococcus spp, making them less sensitive in screening for UTIs in the elderly and pregnant patients who have higher rates of gram positive infections.

PCR VS URINE
CULTURE

Urine cultures fail to spot a high proportion of uropathogens that may be clinically relevant, especially gram positives and fungal pathogens (12% detection rate of non-E. coli pathogens). Expanded Quantitative Urine Culture (EQUC) method identifies more pathogens but takes 48 hours of growth time. If a pathogen is isolated and identified with culture, antimicrobial susceptibility testing takes an additional 1-2 days.

CONFIDENCE IN YOUR PCR RESULTS

Polymerase Chain Reactive (PCR) Testing Method

Molecular methods for detecting pathogens are becoming increasing popular as they offer accurate detection at a fraction of the time as traditional culture-based methods. PCR delivers rapid, sensitive and precise detection of nucleic acids from bacteria and fungus and other microbial organisms.

Why PCR-negative results?

There are multiple reasons a wound may not show pathogens by PCR including prior antibiotic use, sampling error and no pathogen present, i.e., no actual infection. A delay in wound healing may be caused by local factors such as tension, trauma, impaired circulation (e.g. lower leg) as well as the severity and/or cause of the wound. Systemic factors include advanced age, smoking, diabetes, poor nutrition and immunosuppression.

PCR testing method is highly sensitive and highly specific versus conventional testing methods. In particular, having a positive result of the positive-control confirms that the negative result is due to the absence of a target and the sample is a true negative.

Understanding Colonization vs infection

All wounds are colonized but not all wounds are infected. Colonization is the normal presence of microbes in the body that do not cause symptoms or disease. For example, Staphylococcus epidermidis is normally found on the skin and is not usually pathogenic. Infection is the production of toxins by microbes not normally present resulting in disease and a host response, such as inflammation and alike.

Comprehensive Consultations: A Targeted and Customized Approach
The Industry’s Most Precise Approach to Identify and Treat an Infection

Ipsum Diagnostics uses the most advance laboratory testing available to you to identify infections, a technique called real-time Polymerase Chain Reaction (rt-PCR). This technique is faster, more sensitive and more specific than traditional cultures and with lower risk of contamination or specimen non-viability. Additionally, PCR identifies the presence of resistant genes that are critical for you to choose the proper treatment. At Ipsum, we take the extra step of having every test result is carefully reviewed for clinical significance by our team of experienced infectious disease diagnostic specialists prior to our sending the patient results report to you. This is highest level of oversight within the industry and combined with 24-hour results helps to contribute to your ability to provide the best patient care.

Smart Result Reports review of clinical data examples include:

Presence of pathogenic organisms and sensitivities
Resistant genes that affect sensitivity
Targeted medications
Medication allergies
Health conditions, age and more

Consult with the most experienced Infectious Disease Specialists

Occasionally you have questions about a patient case that may be prompted by an unusual testing need or result. You may need insight beyond a specific finding. Get answers quickly from our expert team of board-certified ID Specialists so you can expedite care.

Access to an expert second opinion enhances the clinical decision-making process and provides your patients with timely treatments. Our goal is to provide the most efficient, cost-effective and clinically relevant consultative service to solving difficult clinical results.