Antimicrobial Stewardship Opportunities in Patients with Bacteremia Not Identified by BioFire FilmArray

Ny, Pamela; Ozaki, Aya; Pallarés, Josep Artigas; Nieberg, Paul; Wong-Beringer, Annie

doi:10.1128/jcm.01941-18

Cited by 9 publications

(5 citation statements)

References 22 publications

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“…Compared to the previous version of the test, BCID2 has introduced 16 new targets, many of which have been detected in our study, including E. faecalis, E. faecium, S. epidermidis, Bacteroides fragilis, Salmonella spp., as well as and bla CTX-M . The importance of broadening the BioFire FilmArray BCID panel had been highlighted by a study by Ny et al where a subset of bacteraemia cases caused by organisms not detected by the previous version of the test were associated to adverse clinical outcomes and mainly caused by anaerobes [18]. Moreover, despite we did not detect any carbapenem resistant Gram-negatives due to their low prevalence in the Australian setting, the new capability of BCID2 of detecting carbapenemases is going to be extremely relevant in settings with high prevalence of antimicrobial resistance, both for treatment adjustment and for prompt implementation of infection prevention and control practices [19].…”

Section: Discussionmentioning

confidence: 99%

Performance of the BioFire Blood Culture Identification 2 panel for the diagnosis of bloodstream infections

Peri

Bauer

Bergh

et al. 2022

Heliyon

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Section: Discussionmentioning

confidence: 99%

Performance of the BioFire Blood Culture Identification 2 panel for the diagnosis of bloodstream infections

Peri

Bauer

Bergh

et al. 2022

Heliyon

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“…Isolation of Clostridium species from blood cultures may represent contamination or transient or clinically insignificant bacteremia; however, it can also be an indicator of severe life-threatening infections requiring prompt identification and treatment (41,42). For these reasons, consideration should be given to including a Clostridium target in future iterations of BCID panels (43).…”

Section: Discussionmentioning

confidence: 99%

Clinical Performance of the Novel GenMark Dx ePlex Blood Culture ID Gram-Positive Panel

Carroll

Reid²,

Thornberg³

et al. 2020

J Clin Microbiol

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Rapid identification from positive blood cultures is standard of care (SOC) in many clinical microbiology laboratories. The GenMark Dx ePlex Blood Culture Identification Gram-Positive (BCID-GP) Panel is a multiplex nucleic acid amplification assay based on competitive DNA hybridization and electrochemical detection using eSensor technology. This multicenter study compared the investigational-use-only (IUO) BCID-GP Panel to other methods of identification of 20 Gram-positive bacteria, four antimicrobial resistance genes, and both Pan Candida and Pan Gram-Negative targets that are unique to the BCID-GP Panel. Ten microbiology laboratories throughout the United States collected residual, deidentified positive blood culture samples for analysis. Five laboratories tested both clinical and contrived samples with the BCID-GP Panel. Comparator identification methods included each laboratory’s SOC, which included matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) and automated identification systems as well as targeted PCR/analytically validated real-time PCR (qPCR) with bidirectional sequencing. A total of 2,342 evaluable samples (1,777 clinical and 565 contrived) were tested with the BCID-GP Panel. The overall sample accuracy for on-panel organisms was 89% before resolution of discordant results. For pathogenic Gram-positive targets (Bacillus cereus group, Enterococcus spp., Enterococcus faecalis, Enterococcus faecium, Staphylococcus spp., Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus lugdunensis, Listeria spp., Listeria monocytogenes, Streptococcus spp., Streptococcus agalactiae, Streptococcus anginosus group, Streptococcus pneumoniae, and Streptococcus pyogenes), positive percent agreement (PPA) and negative percent agreement (NPA) ranged from 93.1% to 100% and 98.8% to 100%, respectively. For contamination rule-out targets (Bacillus subtilis group, Corynebacterium, Cutibacterium acnes, Lactobacillus, and Micrococcus), PPA and NPA ranged from 84.5% to 100% and 99.9% to 100%, respectively. Positive percent agreement and NPA for the Pan Candida and Pan Gram-Negative targets were 92.4% and 95.7% for the former and 99.9% and 99.6% for the latter. The PPAs for resistance markers were as follows: mecA, 97.2%; mecC, 100%; vanA, 96.8%; and vanB, 100%. Negative percent agreement ranged from 96.6% to 100%. In conclusion, the ePlex BCID-GP Panel compares favorably to SOC and targeted molecular methods for the identification of 20 Gram-positive pathogens and four antimicrobial resistance genes in positive blood culture bottles. This panel detects a broad range of pathogens and mixed infections with yeast and Gram-negative organisms from the same positive blood culture bottle.

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“…The 2-weeks mortality rate was 28% in patients who received appropriate therapy and 78% in patients who received no antimicrobial therapy [26]. Recently, a study focusing on a rapid-diagnostics platform from positive blood cultures showed that the delay before starting adequate antimicrobial therapy was high for bacteremia due to anaerobes, contributing to higher mortality in this subgroup [27]. Indeed, 59% of the organisms not detected by the platform were anaerobes (mostly Bacteroides and Clostridium), because they were not included in the panel.…”

Section: Discussionmentioning

confidence: 99%

Clinical relevance of Clostridium bacteremia: An 8-year retrospective study

et al. 2020

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Clostridium spp. are recovered from 25% of the blood culture positive with anaerobes. However, the clinical relevance of Clostridium bacteremia has been controverted in the literature, particularly for C. perfringens. We aimed to evaluate the clinical relevance of Clostridium bacteremia, either due to C. perfringens or other Clostridium species, and to identify the risk factors of mortality in these patients. A retrospective cohort study was conducted from January 2010 to April 2018. All the patients with at least one blood culture positive with any Clostridium species were included. Eighty-one patients with a least one blood culture positive with any Clostridium species were included. Seventy patients (86.4%) fulfilled the criteria for clinically relevant bacteremia. Bacteremia due to C. perfringens tended to be less clinically relevant than other Clostridium species but this was not statistically significant (76% vs 91.2%, P=0.09). In case of clinically relevant bacteremia, the 30-day mortality rate was 31.4%. In multivariate analysis, adequate empiric antimicrobial therapy was significantly associated with survival (P=0.03). In conclusion, bacteremia due to C. perfringens or other Clostridium species is usually clinically relevant. This finding was also supported by an improved survival at 30 days when adequate empiric antimicrobial therapy was administered.

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Antimicrobial Stewardship Opportunities in Patients with Bacteremia Not Identified by BioFire FilmArray

Cited by 9 publications

References 22 publications

Performance of the BioFire Blood Culture Identification 2 panel for the diagnosis of bloodstream infections

Performance of the BioFire Blood Culture Identification 2 panel for the diagnosis of bloodstream infections

Clinical Performance of the Novel GenMark Dx ePlex Blood Culture ID Gram-Positive Panel

Clinical relevance of Clostridium bacteremia: An 8-year retrospective study

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