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This study aimed to examine the sensitivity and specificity of ddPCR and the association between bacterial DNA load in whole blood and the time-to-positivity (TTP) of blood culture (BC) in patients with\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      BSI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective study enrolled patients with\n                      <jats:italic>E. coli<\/jats:italic>\n                      BSI confirmed via BC at the Hiroshima University Hospital from June 2023 to August 2024. The\n                      <jats:italic>E. coli<\/jats:italic>\n                      DNA load in whole blood, which was simultaneously obtained from two BC sets, was measured using ddPCR with\n                      <jats:italic>E. coli<\/jats:italic>\n                      specific primer and probe. Whole blood samples from 50 patients with BC positive for pathogens other than\n                      <jats:italic>E. coli<\/jats:italic>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925) and BC negative (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925) were also evaluated using ddPCR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 131 patient samples were analyzed in this study. Of the 81 patients with\n                      <jats:italic>E. coli<\/jats:italic>\n                      BSI, ddPCR detected\n                      <jats:italic>E. coli<\/jats:italic>\n                      DNA in 67 (82.7%). The results of ddPCR for\n                      <jats:italic>E. coli<\/jats:italic>\n                      had a sensitivity of 82.7% (95% CI: 73.1\u201389.4%), specificity 100% (95% CI: 93.0\u2013100%). Patients with positive ddPCR results had significantly shorter TTP than those with negative results (median, 8.8\u00a0h vs. 10.7\u00a0h,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The positivity rate for both BC sets was significantly higher in patients with positive ddPCR results than in those with negative results (89.6% vs. 35.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Among ddPCR-positive patients, septic shock was significantly associated with intestinal perforation, higher\n                      <jats:italic>E. coli<\/jats:italic>\n                      DNA load, higher 28-d mortality, shorter TTP, and higher positivity rate for four bottles of BC than those without septic shock. The\n                      <jats:italic>E. coli<\/jats:italic>\n                      DNA load in whole blood negatively correlated with TTP (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, R\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.38).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:italic>E. coli<\/jats:italic>\n                      DNA load in whole blood is inversely correlated with TTP. Notably, a higher\n                      <jats:italic>E. coli<\/jats:italic>\n                      DNA load is associated with septic shock.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-024-10396-y","type":"journal-article","created":{"date-parts":[[2025,1,5]],"date-time":"2025-01-05T23:25:35Z","timestamp":1736119535000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Clinical diagnostic performance of droplet digital PCR for pathogen detection in patients with Escherichia coli bloodstream infection: a prospective observational study"],"prefix":"10.1186","volume":"25","author":[{"given":"Hiroki","family":"Kitagawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Kojima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayoko","family":"Tadera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuta","family":"Kogasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keitaro","family":"Omori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihito","family":"Nomura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norifumi","family":"Shigemoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiso","family":"Hiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Ohge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,6]]},"reference":[{"key":"10396_CR1","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1007\/s00134-020-05950-6","volume":"46","author":"JF Timsit","year":"2020","unstructured":"Timsit JF, Rupp\u00e9 E, Barbier F, Tabah A, Bassetti M. 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