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 (bla_KPC) 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 bla_KPC–mediated CRE.

中文翻译：

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使用 BioFire FilmArray 血培养鉴定面板从阳性标记的血培养中快速鉴定血流细菌和真菌病原体及其抗生素耐药性决定因素。

背景/目的

直接从标记的血培养物中快速准确地识别病原体及其抗生素耐药性可以帮助临床医生优化早期抗生素治疗并改善临床结果，尤其是在与耐万古霉素肠球菌 (VRE) 和碳青霉烯类引起的高血流感染率相关的环境中耐药肠杆菌科 (CRE)。我们将 BioFire FilmArray 血培养鉴定 (BCID) 面板的结果与用于识别病原体及其抗生素敏感性状态的常规方法的结果进行了比较。

方法

总共分析了 100 个随机选择的阳性血培养物（BACTEC Plus Aerobic/F 瓶或 BACTEC Anaerobic Lytic/10 瓶）。使用MALDI-TOF MS系统（Bruker MALDI Biotyper）和Vitek 2系统进行药敏试验，将FilmArray BCID panel的病原体检测效率与常规方法进行比较。对于从 MALDI Biotyper 和 Vitek 2 获得的差异结果，对抗生素抗性基因进行了测序分析。

结果

在 100 个标记为阳性的血培养物中，94% 的 FilmArray BCID panel 结果与 MALDI Biotyper 结果一致。在 FilmArray BCID 面板中检测到的所有 5 种vanA/vanB基因阳性的 VRE 分离株、12种mecA基因阳性的葡萄球菌属中的10种，以及仅一种肺炎克雷伯菌碳青霉烯酶基因 ( bla _KPC )阳性的肺炎克雷伯菌分离株也与以下结果一致常规药敏试验/分子确认的结果。

结论

FilmArray BCID panel 结果不仅证明与常规血培养鉴定和药敏结果具有良好的相关性，而且提供快速结果，特别是对于 MRSA、VRE 和bla _KPC介导的 CRE的早期检测。