Enhanced detection of sepsis pathogens in hospitalized febrile neutropenia patients using blood culture broths with TaqMan array card.
8 affiliations
- 1Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan. [email protected].
- 2Department of Biosciences, Shaheed Zulfiqar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan. [email protected].
- 3Department of Biosciences, Shaheed Zulfiqar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan.
- 4Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
- 5School of Public Health, Qingdao University, Qingdao, China.
- 6Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, VA, USA.
- 7Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan.
- 8Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
Abstract
Background
In resource-limited settings, febrile neutropenia (FN) is one of the leading causes of morbidity and mortality among immunocompromised individuals particularly those undergoing chemotherapy for malignancies. The clinical diagnosis and management of disease is challenging, due to the diverse range of causative pathogens and overreliance on the traditional diagnostic techniques. TaqMan array card (TAC), a microfluidics-based technique that allows simultaneous and rapid detection of multiple pathogens, addressing these diagnostic needs.Objective
The aim of this study was to determine the role of TAC in improving pathogen identification in hospitalized patients with FN.Methods
This cross-sectional study enrolled 155 FN patients admitted to Aga Khan University and Hospital, Karachi, Pakistan. 9 samples were excluded due to failed post-extraction quality control, yielding 146 samples for final TAC analysis. Both blood cultures and TAC assays were performed on the collected broths. Enrichment strategies were employed to reduce the impact of PCR inhibitors and increase microbial biomass, thereby enhancing the diagnostic sensitivity of TAC.Results
TAC identified a diverse range of pathogens compared with traditional blood culture. Of 155 study participants, 61 (39.1%) were culture positive. At the Ct ≤ 35, at least one pathogen was identified in 37 TAC positive samples. The most frequently detected bacteria were E. coli (13/146, 8.90%), K. pneumoniae (11/146, 7.53%), A. baumannii (4/146, 2.74%), and P. aeruginosa (4/146, 2.74%). TAC showed diagnostic sensitivity of 23.5% for E. coli and 19.6% for K. pneumoniae at the primary Ct ≤ 35 threshold, with specificity above 98% for both. In multivariable penalized logistic regression, K. pneumoniae, E. coli, P. aeruginosa, and A. baumannii were independently associated with higher mortality. Antimicrobial resistance profiling demonstrated carbapenem and cephalosporin resistance across all three blood culture types.Conclusion
The findings of this study suggest that TAC identifies a wider range of pathogen compared with traditional blood culture in FN patients. Only blood culture was able to detect Candida tropicalis in this experiment; TAC was unable to identify any fungal infection, highlighting the panel's current flaw. Multicenter studies are needed to validate these results and assess the effectiveness of TAC in broader clinical settings.
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BibTeX
@article{kabir2026enhanced,
title = {{Enhanced detection of sepsis pathogens in hospitalized febrile neutropenia patients using blood culture broths with TaqMan array card.}},
author = {Furqan Kabir and Hammad Afzal Kayani and Dur E Shahwar and Rufei Ma and Sara Iqbal and Akram Hussain and Jawaid Hussain and Adil Kalam and Fatima Aziz and Sehrish Munir and Farrukh Qazi and Jie Liu and Eric Houpt and Erum Khan and Junaid Iqbal and Asad Ali},
journal = {BMC infectious diseases},
year = {2026},
month = jul,
doi = {10.1186/s12879-026-14004-z},
url = {https://europepmc.org/article/MED/42919227},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Enhanced detection of sepsis pathogens in hospitalized febrile neutropenia patients using blood culture broths with TaqMan array card.
AU - Furqan Kabir
AU - Hammad Afzal Kayani
AU - Dur E Shahwar
AU - Rufei Ma
AU - Sara Iqbal
AU - Akram Hussain
AU - Jawaid Hussain
AU - Adil Kalam
AU - Fatima Aziz
AU - Sehrish Munir
AU - Farrukh Qazi
AU - Jie Liu
AU - Eric Houpt
AU - Erum Khan
AU - Junaid Iqbal
AU - Asad Ali
PY - 2026
DA - 2026/07/01
JO - BMC infectious diseases
DO - 10.1186/s12879-026-14004-z
UR - https://europepmc.org/article/MED/42919227
AB - Background In resource-limited settings, febrile neutropenia (FN) is one of the leading causes of morbidity and mortality among immunocompromised individuals particularly those undergoing chemotherapy for malignancies. The clinical diagnosis and management of disease is challenging, due to the diverse range of causative pathogens and overreliance on the traditional diagnostic techniques. TaqMan array card (TAC), a microfluidics-based technique that allows simultaneous and rapid detection of multiple pathogens, addressing these diagnostic needs.Objective The aim of this study was to determine the role of TAC in improving pathogen identification in hospitalized patients with FN.Methods This cross-sectional study enrolled 155 FN patients admitted to Aga Khan University and Hospital, Karachi, Pakistan. 9 samples were excluded due to failed post-extraction quality control, yielding 146 samples for final TAC analysis. Both blood cultures and TAC assays were performed on the collected broths. Enrichment strategies were employed to reduce the impact of PCR inhibitors and increase microbial biomass, thereby enhancing the diagnostic sensitivity of TAC.Results TAC identified a diverse range of pathogens compared with traditional blood culture. Of 155 study participants, 61 (39.1%) were culture positive. At the Ct ≤ 35, at least one pathogen was identified in 37 TAC positive samples. The most frequently detected bacteria were E. coli (13/146, 8.90%), K. pneumoniae (11/146, 7.53%), A. baumannii (4/146, 2.74%), and P. aeruginosa (4/146, 2.74%). TAC showed diagnostic sensitivity of 23.5% for E. coli and 19.6% for K. pneumoniae at the primary Ct ≤ 35 threshold, with specificity above 98% for both. In multivariable penalized logistic regression, K. pneumoniae, E. coli, P. aeruginosa, and A. baumannii were independently associated with higher mortality. Antimicrobial resistance profiling demonstrated carbapenem and cephalosporin resistance across all three blood culture types.Conclusion The findings of this study suggest that TAC identifies a wider range of pathogen compared with traditional blood culture in FN patients. Only blood culture was able to detect Candida tropicalis in this experiment; TAC was unable to identify any fungal infection, highlighting the panel's current flaw. Multicenter studies are needed to validate these results and assess the effectiveness of TAC in broader clinical settings.
SN - 1471-2334
ER -