1. Rapid identification of bloodstream bacterial and fungal pathogens and their antibiotic resistance determinants from positively flagged blood cultures using the BioFire FilmArray blood culture identification panel
- Author
-
Xiang-Jun Chen, Chun-Min Kang, Chen-Ching Hsu, Po-Ren Hsueh, Ching-Chin Chih, Tai Fen Lee, Ping-Hung Chen, and Lee-Jene Teng
- Subjects
0301 basic medicine ,Microbiology (medical) ,Antifungal Agents ,Pathogen detection ,medicine.drug_class ,Klebsiella pneumoniae ,030106 microbiology ,Antibiotics ,Taiwan ,lcsh:QR1-502 ,Bacteremia ,Resistance genes ,lcsh:Microbiology ,Microbiology ,03 medical and health sciences ,0302 clinical medicine ,Antibiotic resistance ,Drug Resistance, Fungal ,Drug Resistance, Bacterial ,medicine ,Humans ,Immunology and Allergy ,Blood culture ,Prospective Studies ,030212 general & internal medicine ,Multiplex PCR assay ,Bacteria ,General Immunology and Microbiology ,medicine.diagnostic_test ,biology ,business.industry ,SCCmec ,Fungi ,General Medicine ,biochemical phenomena, metabolism, and nutrition ,biology.organism_classification ,bacterial infections and mycoses ,Enterobacteriaceae ,Anti-Bacterial Agents ,Bacterial Typing Techniques ,Rapid identification ,Infectious Diseases ,Blood cultures ,Blood Culture ,Vancomycin-resistant enterococci ,Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ,BioFire FilmArray blood culture identification panel ,business ,Fungemia - Abstract
Background/purpose Rapid and accurate identification of pathogens and their antibiotic resistance directly from flagged blood cultures can aid clinicians in optimizing early antibiotic treatment and improve the clinical outcomes, especially in settings associated with high rates of bloodstream infection caused by vancomycin-resistant Enterococci (VRE) and carbapenem-resistant Enterobacteriaceae (CRE). We compared the results of the BioFire FilmArray Blood Culture Identification (BCID) panel with those of conventional methods for identifying the pathogens and their antibiotic susceptibility status. Methods In total, 100 randomly selected positive blood cultures (BACTEC Plus Aerobic/F bottles or BACTEC Anaerobic Lytic/10 bottles) were analyzed. The pathogen detection efficiency of FilmArray BCID panel was compared with that of conventional method using MALDI-TOF MS system (Bruker MALDI Biotyper) and susceptibility testing by the Vitek 2 system. The sequencing analysis of antibiotic resistance genes was performed for discrepant results obtained from MALDI Biotyper and Vitek 2. Results Among the 100 positively flagged blood cultures, 94% of FilmArray BCID panel results were consistent with the MALDI Biotyper results. All five VRE isolates positive for vanA/vanB genes, 10 of 12 Staphylococcus species positive for mecA gene, and only one Klebsiella pneumoniae isolate positive for K. pneumoniae carbapenemase gene (blaKPC) detected in the FilmArray BCID panel were also concordant with results by the results by conventional susceptibility testing/molecular confirmation. Conclusions The FilmArray BCID panel results not only demonstrated good correlation with conventional blood culture identification and susceptibility results but also provided results rapidly, especially for the early detection of MRSA, VRE and blaKPC–mediated CRE.
- Published
- 2020