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The Era of Molecular and Other Non-Culture-Based Methods in Diagnosis of Sepsis
Nicasio Mancini, Silvia Carletti, Nadia Ghidoli, Paola Cichero, Roberto Burioni and Massimo Clementi Clin. Microbiol. Rev. 2010, 23(1):235. DOI: 10.1128/CMR.00043-09.

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CLINICAL MICROBIOLOGY REVIEWS, Jan. 2010, p. 235–251 0893-8512/10/$12.00 doi:10.1128/CMR.00043-09 Copyright © 2010, American Society for Microbiology. All Rights Reserved.

Vol. 23, No. 1

The Era of Molecular and Other Non-Culture-Based Methods in Diagnosis of Sepsis
Nicasio Mancini,* Silvia Carletti, Nadia Ghidoli, Paola Cichero,Roberto Burioni, and Massimo Clementi
Laboratorio di Microbiologia e Virologia, Universita “Vita-Salute” San Raffaele, Diagnostica e Ricerca San Raffaele, Milano, Italia ` INTRODUCTION .......................................................................................................................................................235Definitions................................................................................................................................................................236 The Clinical Microbiology Laboratory in the Management of Sepsis ............................................................236 CLINICAL ROLE OF BLOOD CULTURES..........................................................................................................236 The Limitsof a Gold Standard: Factors Influencing Blood Culture Sensitivity...........................................237 Blood volume .......................................................................................................................................................237 Time from sampling toincubation...................................................................................................................237 Fastidious pathogens and antimicrobial therapy...........................................................................................237 Turnaround time to definitive identification ..................................................................................................237 NUCLEIC ACID-BASED DIAGNOSTIC TECHNOLOGIES APPLIED TO SEPSIS......................................237 Different Strategies and Different Results ..........................................................................................................237 Purification of Nucleic Acids from Blood Cultures or from Clinical Samples ..............................................238 Nucleic acid extraction from blood culturebottles........................................................................................238 Nucleic acid extraction from whole blood, serum, or plasma ......................................................................238 Purification of fungal nucleic acids from clinical samples...........................................................................238 Assays for Identification of Pathogens from Positive Blood Cultures............................................................239 PCR-based methods............................................................................................................................................239 (i) Pathogen-specific assays...........................................................................................................................239 (ii) Broad-range assays...
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