Infectious disease (bacteria and fungi), gram-positive organism identification and drug resistance element detection, DNA (20 gram-positive bacterial targets, 4 resistance genes, 1 pan gram-negative bacterial target, 1 pan Candida target), blood culture,
CPT4 code
Name of the Procedure:
Infectious Disease (Bacteria and Fungi) Identification and Drug Resistance Element Detection via Blood Culture
Summary
This procedure is a diagnostic test that detects the presence of specific bacteria and fungi in the bloodstream. It also identifies drug resistance genes to help determine the most effective treatment. The test focuses on 20 gram-positive bacterial targets, 4 resistance genes, 1 pan gram-negative bacterial target, and 1 pan Candida target.
Purpose
The procedure is used to diagnose infections caused by bacteria and fungi, particularly those that are resistant to common antibiotics. It aims to quickly identify the infectious agent and its resistance profile to guide appropriate therapy.
Indications
- Symptoms of sepsis such as fever, chills, rapid heart rate, and confusion.
- Persistent or recurring bloodstream infections.
- Monitoring known infections for drug resistance.
- Patients with compromised immune systems susceptible to infections.
Preparation
Generally, no special preparation is required. In some cases, fasting or pausing certain medications may be recommended. A prior health assessment and possibly other diagnostic tests will be performed to ensure the procedure is appropriate.
Procedure Description
- Sample Collection: Blood is drawn from the patient, typically from a vein in the arm, using a sterile technique.
- Culture and Analysis: The blood sample is cultured in specialized media to grow any bacteria or fungi present.
- DNA Testing: Advanced technologies like polymerase chain reaction (PCR) are used to identify the DNA of specific gram-positive bacteria, resistance genes, pan gram-negative targets, and Candida.
- Results Interpretation: Once identified, the pathogens and their resistance profiles are analyzed to determine the appropriate treatment.
Duration
The entire process, from blood draw to results, can take several hours to a few days depending on the pathogens present and the complexity of the analysis.
Setting
This procedure is typically performed in a hospital or a specialized diagnostic laboratory.
Personnel
- Phlebotomist or nurse for blood collection
- Medical laboratory technologists for culture and analysis
- Clinical microbiologists for interpretation of results
- Physicians to review and act on the test results
Risks and Complications
- Common: Mild pain or bruising at the blood draw site.
- Rare: Infection at the puncture site, excessive bleeding, or fainting. All complications are usually minor and easily managed.
Benefits
- Rapid and accurate identification of the infectious agent.
- Determination of drug resistance, leading to effective treatment.
- Reduced time to appropriate therapy, improving patient outcomes.
Recovery
No special recovery is generally needed apart from routine wound care at the site of blood draw. Normal activities can resume immediately unless otherwise advised by the healthcare provider.
Alternatives
- Traditional blood culture without DNA testing, which may take longer to yield results.
- Specific tests targeting only suspected pathogens. Pros: Typically less complex and less expensive. Cons: Slower diagnosis and less comprehensive coverage.
Patient Experience
- During: Minimal discomfort from the blood draw.
- After: Little to no downtime, with a minor risk of bruising or soreness. Pain management is generally not necessary, but local anesthesia can be used if needed for comfort.
By following these steps and considering all aspects of this procedure, healthcare providers can effectively diagnose and manage bloodstream infections, optimizing patient care and outcomes.