Optimizing Clinical Indicators in Hematologic Malignancies and Sepsis Using ddPCR: A Retrospective Study.

Area of Science:

• Infectious Diseases
• Molecular Diagnostics
• Hematology

Background:

• Early antibacterial treatment is crucial for hematologic malignancy (HM) patients with sepsis.
• Droplet digital PCR (ddPCR) offers rapid pathogen and antimicrobial resistance (AMR) gene detection.
• The clinical utility of ddPCR in HM patients with sepsis remains under investigation.

Purpose of the Study:

• To systematically evaluate the role of ddPCR in the diagnosis of sepsis in HM patients.
• To assess the impact of ddPCR on clinical outcomes and antimicrobial stewardship.
• To compare ddPCR performance against traditional blood cultures (BC).

Main Methods:

• A study involving 400 HM patients with sepsis from January 2023 to March 2025.
• Comparison of ddPCR combined with BC (150 patients) versus BC alone (250 patients).
• Propensity score matching (PSM), subgroup, and sensitivity analyses were employed to evaluate outcomes including 28-day mortality and antibiotic use density (AUD).

Main Results:

• ddPCR demonstrated a higher positive rate (49.33% vs. 17.50%) and significantly faster turnaround time (4.06h vs. 72.47h) compared to BC.
• The ddPCR group showed reduced 28-day mortality (HR=0.55), improved clinical response rates, and greater inflammatory marker decline.
• Antimicrobial optimization guided by ddPCR led to improved efficacy (85.11%) and reduced AUD (OR=-28.93).

Conclusions:

• ddPCR significantly outperforms BC in diagnostic efficiency for HM patients with sepsis.
• ddPCR accelerates pathogen and AMR gene identification, leading to optimized antibacterial therapy and improved clinical outcomes.
• The study supports the implementation of ddPCR for managing sepsis in immunosuppressed populations.