The aim of this project is to test the utility of The Gene Z device (as of 2018 Gene Z no longer being used), now using In-Dx and other rapid identification techniques that the investigators have developed in the lab on clinically obtained bodily fluid samples taken from patients with suspected infection or sepsis based on having three of four positive Systemic Inflammatory Response Syndrome markers, or having a known infection for which a specimen is being collected. Specimens will be collected at the University of Michigan Health/Sparrow and McLaren Greater Lansing , processed in our lab and stored for analysis at a later date to determine if the microbial pathogens identified by current methods of culture, as well as pathogen susceptibility to antibiotics by culture results, can be identified by the GeneZ technology (no longer in use) or other developed technology accurately, and more timely. It will not affect current patient care nor impact patient care, which will continue in the standard fashion today for sepsis. Results will be compared to standard culture results and antibiotic sensitivities. A secondary aim is related to the antibiotic resistance of the organism causing the infection in an attempt to determine if there are specific characteristics of the organism that allow it to be resistant to certain antibiotics. This requires analysis of the genetic material of the organism in our laboratory. Because there are also human cells in the specimens collected, with separate permission we will evaluate the human genome of the patient with the infection to determine characteristics and conditions that may predict a complicated versus uncomplicated disease course.
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Adult patients who undergo evaluation for suspected sepsis who have peripheral blood cultures and/or urine samples obtained and patient characteristics recorded. In addition those that have an obvious infection without sepsis will be consented. Those that have other bodily fluids involved in addition will also be included, with or without SIRS criteria. (Sputum, wound drainage, CSF, oral or nasal secretions).
Cohort
Retrospective
Gene Z or other rapid diagnostic techniques developed in our lab (as of 2018 not using Gene Z - now using In-Dx along with other developed techniquesregularly)
DeviceThe Gene Z device (no longer in use) and now using In-Dx created in our lab, and other rapid diagnostic techniques that we have developed in our lab will be used to analyze previously processed specimens for microbial organisms and compared to prior culture and sensitivity results. It is not a separate arm - all samples will be cultured in lab per standard protocol and then the Gene Z device or other rapid diagnostic techniques developed in our lab will be used to re-analyze at a later date specimens that were previously frozen and stored and compared to culture results
Correlation of microbial identification with culture results from clinical laboratory
Frozen microbial specimens will be transported to an off site laboratory for analysis with the GeneZ or other point of care or rapid diagnostic technique or device, with investigators blinded to the final culture results of the specimen - positive or negative. Comparison will be made between final culture result and GeneZ identification of organism or other method as developed in the investigators' lab.
Microbial Resistance Gene Pattern
Frozen specimens will be analyzed via real time PCR and genetic analysis of the organism to identify microorganism resistance gene patterns of organisms identified by the GeneZ device or other rapid diagnostic technique or point of care device. These will be compared to the antibiotic sensitivity results from the culture and sensitivity reports done in the clinical laboratory.
Human genome analysis in consented patients
With separate consent starting on specimens collected in 2026 and going forward will analyze the human genome from cells in the specimens collected that are of human origin, and compare to severity of illness to attempt to determine if there are genetic predictors of the patient's infectious disease course.
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