Molecular rapid diagnostic assays associated with antimicrobial stewardship have proven effective for the early adaptation of empiric therapy in bloodstream infections. The ePlex^® BCID (GenMark Diagnostics) Panels allow identification of 56 bacteria and fungi and 10 resistance genes in 90 min directly from positive blood cultures. We prospectively evaluated 187 sepsis episodes at Grenoble University Hospital and retrospectively analyzed the cases to measure the potential clinical impact of the ePlex BCID results. Identification of all pathogens was obtained for 164/187 (88%) bloodstream infections with 100% detection of antimicrobial resistance genes (17 bla_CTX-M, 1 vanA, and 17 mecA genes). Only 15/209 (7%) strains were not covered by the panels. Sensitivity for detection of micro-organisms targeted by the RUO BCID-GP, BCID-GN, and BCID-FP Panels was respectively 84/84 (100%), 103/107 (96%), and 14/14 (100%). Interestingly, accurate identification of all pathogens was achieved in 15/17 (88%) polymicrobial samples. Retrospective analysis of medical records showed that a modification of antimicrobial treatment would have been done in 45% of the patients. Treatment modifications would have been an optimization of empiric therapy, a de-escalation or an escalation in respectively 16, 17, and 11% of the patients. Moreover, 11% of the samples were classified as contaminants or not clinically relevant and would have led to early de-escalation or withdrawal of any antibiotic. Detection of resistance genes in addition to identification alone increased escalation rate from 4 to 11% of the patients. Absence of the ePlex result was considered a lost opportunity for therapy modification in 28% of patients.

与抗菌素管理相关的分子快速诊断测定已被证明可有效地用于经验疗法在血流感染中的早期适应。所述ePlex ^® BCID（GenMark Diagnostics）上面板允许56种细菌和真菌以及从阳性血液培养物在直接90分钟10个抗性基因的鉴定。我们对格勒诺布尔大学医院的187例脓毒症发作进行了前瞻性评估，并回顾性分析了这些病例，以评估ePlex BCID结果的潜在临床影响。通过100％检测抗微生物耐药基因，鉴定出164/187（88％）血液感染的所有病原体（17bla _CTX-M，1 货车和17 协会基因）。面板未覆盖仅15/209（7％）菌株。RUO BCID-GP，BCID-GN和BCID-FP面板针对微生物的检测灵敏度分别为84/84（100％），103/107（96％）和14/14（100％） 。有趣的是，在15/17（88％）的微生物样本中实现了对所有病原体的准确鉴定。病历的回顾性分析表明，将对45％的患者进行抗微生物治疗的修改。修改治疗方案将是分别对16％，17％和11％的患者进行经验治疗，降级或升级的优化。此外，11％的样品被归类为污染物或与临床无关，将导致早期降级或撤消任何抗生素。除单独鉴定外，检测抗性基因可将患病率从4％提升至11％。缺少ePlex结果被认为有28％的患者失去了修改治疗的机会。