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Competing Interests: The authors have no funding or conflicts of interest to disclose.

This study aimed to assess the therapeutic effects of implementing the BioFire® Blood Culture Identification 2 (BCID2) Panel (bioMérieux, Marcy l'Etoile, France) in the clinical practice of children with sepsis. This retrospective cross-sectional study included children from 15 days of age to 18 years old with sepsis and of whom the BCID2 Panel was studied from the positive blood culture. If the antimicrobial treatment was changed according to the results of BCID2 Panel, it was recorded and re-grouped as targeted antimicrobial therapy, de-escalation of the antimicrobial treatment and shifting to another antimicrobial drug if any antimicrobial resistance was detected. Seven-days and thirty-days mortality rate was recorded. Thirty-two patients with 36 septic episodes with positive BCID2 Panel results were included. The median age was 10 months 15 days (ranging from 15 days to 16.5 years). The mean difference between having positive results by the BCID2 Panel and conventional culture methods was 82.2 ± 45.4 h (ranging from 12.3 to 207 h). Effect of the BCID2 Panel on the antimicrobial treatment was detected in 69.4% of the episodes (n = 25). Glycopeptides were ceased at 6 patients, piperacillin/tazobactam was ceased at 6 patients, and cefotaxime was ceased at one patient and de-escalation was achieved in 13 episodes which formed the 36.1% of the initial antimicrobial treatment. Conclusion: The BCID2 Panel had an important impact on the patients care and optimization according to the principles of antimicrobial stewardship. The BCID2 Panel may be one of the key items for rapid and accurate diagnosis in children with sepsis. Blood culture is still the mainstay for especially detection of antimicrobial drug resistance, while BCID2 tests had several advantages such as speed and diagnostic accuracy as good as blood culture. What is Known: • The BioFire® Blood Culture Identification 2 (BCID2) Panel (bioMérieux, Marcy l'Etoile, France) is a well-validated assay that allows for the simultaneous identification of 43 nucleic acid targets associated with bloodstream infections within about 1 h. What is New: • BCID2 Panel had a direct impact on the patient's treatment decision at the 69.4% of the sepsis episodes. • The clinicians received the microbiological results 82.2 h earlier with BCID2 panel compared to blood culture methods with antimicrobial resistance and de-escalation of the antimicrobial drugs was achieved at 13 episodes which formed the 36.1% of the initial treatment. [ABSTRACT FROM AUTHOR]

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Objective: In this study we aimed to detect, identification and distribution of the Candida species in blood and urine samples; and antifungal susceptibility of Candida bloodstream isolates in geriatric patients Methods: All Candida species isolated from blood and urine cultures samples of patients over than 65 years of during the period December 2011-November 2014 in İzmir Tepecik Training and Research Hospital were enrolled in this study. For Candida species identification conventional methods, colony appearance in candida chromogenic agar and for some unidentified isolates API ID32C AUX (BioMérieux, France) was used. Antifungal susceptibility testing of the isolates was performed with API ATB Fungus 3 (BioMérieux, France). Results: During the study period 681 Candida species were isolated in blood and urine samples of patients over than 65 years. When the sample species were evaluated, Candida species detected in 561(82.4%) urine sample, and 120 (17.6%) blood samples. Most isolated species were respectively detected C. albicans (47.0%), C.parapsilosis (16.0%), C.tropicalis (15.9%), C.glabrata (12.2%), C.kefy (3.7%) and C.krusei (2.8%). C. albicans detected the most common in urine samples (51.7 %), on the other hand C.parapsilosis the most common species in blood samples (50.8%). In general surgery unit, C.tropicalis was found as the most common isolate. On the other hand C.albicans the most common species in the other units and services. C.parapsilosis rate in blood cultures increased with age. Antifungal susceptibility of the Candida bloodstream isolates were detected as 97.5% for flucytosine, 95.8% for amfotericin B, 82.5% for fluconazole, 91.7% for itraconazole and 77.5% for voriconazole. Conclusion: The most frequently isolated yeast species in blood and urinesamples of geriatric patients has been found C. albicans. C.parapsilosis especially frequently isolated from blood cultures and increasing the frequency with age. Voriconazole in Candida species is notable for low sensitivity rates. [ABSTRACT FROM AUTHOR]