Rapid Direct Identification of Microbial Pathogens and Antimicrobial Resistance Genes in Positive Blood Cultures Using a Fully Automated Multiplex PCR Assay

Overview

Journal J Korean Med Sci

Specialty General Medicine

Date 2024 May 7

PMID 38711319

Authors

Keun Ju Kim

Seung Gyu Yun

Yunjung Cho

Chang Kyu Lee

Myung-Hyun Nam

Affiliations

Soon will be listed here.

Abstract

This study assessed the performance of the BioFire Blood Culture Identification 2 (BCID2) panel in identifying microorganisms and antimicrobial resistance (AMR) profiles in positive blood cultures (BCs) and its influence on turnaround time (TAT) compared with conventional culture methods. We obtained 117 positive BCs, of these, 102 (87.2%) were correctly identified using BCID2. The discordance was due to off-panel pathogens detected by culture (n = 13), and additional pathogens identified by BCID2 (n = 2). On-panel pathogen concordance between the conventional culture and BCID2 methods was 98.1% (102/104). The conventional method detected 19 carbapenemase-producing organisms, 14 extended-spectrum beta-lactamase-producing Enterobacterales, 18 methicillin-resistant spp., and four vancomycin-resistant . BCID2 correctly predicted 53 (96.4%) of 55 phenotypic resistance patterns by detecting AMR genes. The TAT for BCID2 was significantly lower than that for the conventional method. BCID2 rapidly identifies pathogens and AMR genes in positive BCs.

Citing Articles

Opportunity for early de-escalation of antibiotics in Enterobacterales bacteremia with multiplex PCR rapid diagnostic technology.

Deja E, Greenfield A, Sastry S, Rittmann B Antimicrob Steward Healthc Epidemiol. 2025; 5(1):e18.

PMID: 39911507 PMC: 11795432. DOI: 10.1017/ash.2024.488.

References

Berinson B, Both A, Berneking L, Christner M, Lutgehetmann M, Aepfelbacher M . Usefulness of BioFire FilmArray BCID2 for Blood Culture Processing in Clinical Practice. J Clin Microbiol. 2021; 59(8):e0054321. PMC: 8373244. DOI: 10.1128/JCM.00543-21. View

Son J, Song J, Ko K, Yeom J, Ki H, Kim S . Bloodstream infections and clinical significance of healthcare-associated bacteremia: a multicenter surveillance study in Korean hospitals. J Korean Med Sci. 2010; 25(7):992-8. PMC: 2890898. DOI: 10.3346/jkms.2010.25.7.992. View

Kim K, Yun S, Cho Y, Nam M, Jin Ko Y, Lee C . Evaluation of a sterile, filter-based, in-house method for rapid direct bacterial identification and antimicrobial susceptibility testing using positive blood culture. Eur J Clin Microbiol Infect Dis. 2023; 42(6):691-700. DOI: 10.1007/s10096-023-04592-y. View

Peri A, Bauer M, Bergh H, Butkiewicz D, Paterson D, Harris P . Performance of the BioFire Blood Culture Identification 2 panel for the diagnosis of bloodstream infections. Heliyon. 2022; 8(7):e09983. PMC: 9304729. DOI: 10.1016/j.heliyon.2022.e09983. View

Peker N, Couto N, Sinha B, Rossen J . Diagnosis of bloodstream infections from positive blood cultures and directly from blood samples: recent developments in molecular approaches. Clin Microbiol Infect. 2018; 24(9):944-955. DOI: 10.1016/j.cmi.2018.05.007. View

Graff K, Palmer C, Anarestani T, Velasquez D, Hamilton S, Pretty K . Clinical Impact of the Expanded BioFire Blood Culture Identification 2 Panel in a U.S. Children's Hospital. Microbiol Spectr. 2021; 9(1):e0042921. PMC: 8552780. DOI: 10.1128/Spectrum.00429-21. View

Tabak Y, Vankeepuram L, Ye G, Jeffers K, Gupta V, Murray P . Blood Culture Turnaround Time in U.S. Acute Care Hospitals and Implications for Laboratory Process Optimization. J Clin Microbiol. 2018; 56(12). PMC: 6258864. DOI: 10.1128/JCM.00500-18. View

Banerjee R, Humphries R . Rapid Antimicrobial Susceptibility Testing Methods for Blood Cultures and Their Clinical Impact. Front Med (Lausanne). 2021; 8:635831. PMC: 7987685. DOI: 10.3389/fmed.2021.635831. View

Banerjee R, Komarow L, Virk A, Rajapakse N, Schuetz A, Dylla B . Randomized Trial Evaluating Clinical Impact of RAPid IDentification and Susceptibility Testing for Gram-negative Bacteremia: RAPIDS-GN. Clin Infect Dis. 2020; 73(1):e39-e46. PMC: 8246790. DOI: 10.1093/cid/ciaa528. View

10.

McNamara J, Righi E, Wright H, Hartel G, Harris P, Paterson D . Long-term morbidity and mortality following bloodstream infection: A systematic literature review. J Infect. 2018; 77(1):1-8. DOI: 10.1016/j.jinf.2018.03.005. View

11.

Kim J, Lim Y . Prevalence of derepressed ampC mutants and extended-spectrum beta-lactamase producers among clinical isolates of Citrobacter freundii, Enterobacter spp., and Serratia marcescens in Korea: dissemination of CTX-M-3, TEM-52, and SHV-12. J Clin Microbiol. 2005; 43(5):2452-5. PMC: 1153749. DOI: 10.1128/JCM.43.5.2452-2455.2005. View

12.

Sparks R, Balgahom R, Janto C, Polkinghorne A, Branley J . Evaluation of the BioFire Blood Culture Identification 2 panel and impact on patient management and antimicrobial stewardship. Pathology. 2021; 53(7):889-895. DOI: 10.1016/j.pathol.2021.02.016. View

13.

Grohs P, Remaud E, Lath C, Vuong K, Parolini M, Dannaoui E . Comparison of the New VITEK MS PRIME System with the Matrix-Assisted Laser Desorption Ionization Biotyper Microflex LT for the Identification of Microorganisms. Ann Lab Med. 2023; 43(6):574-584. PMC: 10345180. DOI: 10.3343/alm.2023.43.6.574. View

14.

Chen F, Huang I, Wang C, Chen P, Wang H, Lai J . mecA-positive Staphylococcus aureus with low-level oxacillin MIC in Taiwan. J Clin Microbiol. 2012; 50(5):1679-83. PMC: 3347131. DOI: 10.1128/JCM.06711-11. View

15.

Sze D, Lau C, Chan T, Ma E, Tang B . Comparison of novel rapid diagnostic of blood culture identification and antimicrobial susceptibility testing by Accelerate Pheno system and BioFire FilmArray Blood Culture Identification and BioFire FilmArray Blood Culture Identification 2 panels. BMC Microbiol. 2021; 21(1):350. PMC: 8684256. DOI: 10.1186/s12866-021-02403-y. View

16.

Park J, Kwon M, Hong K, Lee H, Yong D . European Committee on Antimicrobial Susceptibility Testing-Recommended Rapid Antimicrobial Susceptibility Testing of , , and From Positive Blood Culture Bottles. Ann Lab Med. 2023; 43(5):443-450. PMC: 10151279. DOI: 10.3343/alm.2023.43.5.443. View

17.

Jonasson E, Matuschek E, Kahlmeter G . The EUCAST rapid disc diffusion method for antimicrobial susceptibility testing directly from positive blood culture bottles. J Antimicrob Chemother. 2020; 75(4):968-978. PMC: 7069491. DOI: 10.1093/jac/dkz548. View

18.

Kim D, Lee H, Choi J, Croney C, Park K, Park H . The Changes in Epidemiology of Imipenem-Resistant Bacteremia in a Pediatric Intensive Care Unit for 17 Years. J Korean Med Sci. 2022; 37(24):e196. PMC: 9247723. DOI: 10.3346/jkms.2022.37.e196. View

19.

Juttukonda L, Katz S, Gillon J, Schmitz J, Banerjee R . Impact of a Rapid Blood Culture Diagnostic Test in a Children's Hospital Depends on Gram-Positive versus Gram-Negative Organism and Day versus Night Shift. J Clin Microbiol. 2019; 58(4). PMC: 7098773. DOI: 10.1128/JCM.01400-19. View

20.

Cheong H, Park K, Kim H, Kim S, Kim B, Moon C . Core Elements for Implementing Antimicrobial Stewardship Programs in Korean General Hospitals. Infect Chemother. 2023; 54(4):637-673. PMC: 9840955. DOI: 10.3947/ic.2022.0171. View