There are several reports of Ct values of RT PCR assays for COVID 19 being associated with disease severity and infectivity. We studied the correlation between Ct values and disease severity and mortality at our hospital;. All patients with RT PCR diagnosed COVID 19 illness admitted at the study site and for whom Ct values were available were included in the study. The patients with mild disease had significantly lower Ct values than patients with severe disease but had also been tested significantly earlier in the illness than those with severe disease. The patients who died had significantly lower Ct values than patients who survived but here again they had significantly shorter duration of symptoms before testing. We therefore recommend that the time of testing since onset of symptoms should be controlled for while correlating Ct values with disease severity.
Bloodstream infections (BSIs) remain a leading cause of morbidity and mortality especially in intensive care units across the world and timely appropriate antimicrobial therapy is a corner stone in its treatment (i) To compare the time difference to diagnose BSIs between FABCID2 and identification and sensitivity by automated systems (ii) To analyse the clinical utility of the FABCID2 panel in positive blood samples among ICU patients.This was a prospective study done from July 2020 to August 2020 where consecutive thirty positive blood culture received from ICUs were processed for gram stain, culture and antimicrobial susceptibility along with performing PCR with BioFire FilmArray Blood Culture Identification2 (FABCID2) Panel. Time line of positive blood culture from receipt to report generation at multiple points were captured along with impact of results in terms of changing antimicrobial therapy of the patients and outcome. : A total of 38 microorganisms were identified from 30 patients. In 70% (21/30) of patients, the result of FABCID2 and growth in culture matched completely, in 23% (7/30) they matched partially and in 6% they did not match. The match between genotypic markers in the assay and phenotypic susceptibility was 100%. FABCID 2 results prompted clinicians to change the antimicrobials prescribed to 33% of total patients (escalation was done in 23.3% of patients and de-escalation was done in 10%. Clinical utility of the FABCID2 Panel in Identification of microorganisms and resistance markers from Positive Blood Culture Bottles is significant which should be used in conjunction with conventional methods to impact patient outcome and antimicrobial stewardship program.
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