Evaluation of the ePlex Blood Culture Identification Panels for Detection of Pathogens in Bloodstream Infections

Huang, Te-Din; Melnik, Ekaterina; Bogaerts, Pierre; Evrard, Stéphanie; Glupczynski, Youri

doi:10.1128/jcm.01597-18

Cited by 64 publications

(47 citation statements)

References 24 publications

(29 reference statements)

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“…vanA-containing enterococci are resistant to both vancomycin and teicoplanin, whereas vanB-containing enterococci remain susceptible to teicoplanin (46). Performance among all samples, both clinical and contrived, revealed PPA and NPA for vanA of 96.8% and 99.0%, respectively, and 100% PPA and NPA for vanB detection, similar to the performance reported for other rapid blood culture panels and the only other publication on the ePlex BCID Panels (25,26,34). Likewise, the overall PPA and NPA for mecA detection of 97.1% and 95.3%, respectively, in the clinical samples among staphylococci are similar to those reported for other nucleic acid-based rapid methods (25,26).…”

Section: Discussionsupporting

confidence: 75%

“…Both the Pan Candida and Pan Gram-Negative targets performed well for the on-panel organisms in the clinical samples (PPA range, 92.4% to 95.7%, NPA range, 99.5% to 99.9%). Using ePlex RUO BCID panels, Huang et al noted 100% specificity for the Pan Gram-Negative targets and one false negative, an E. coli isolate that was not detected out of a total of six samples that had a Gram-negative organism (34).…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 75%

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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show abstract

“…However, one case of Candida inconspicua (not targeted by the BCID-FP panel) was missed. The combination of blood culture and ePlex reduced the turn-around time from 72-96 to 10 h (Huang et al, 2019). The Accelerate Pheno system (Accelerate Diagnostics) is a fully automated system utilizing gel electrofiltration and fluorescence in situ hybridization (FISH) for the identification of two Candida species as well as bacteria, directly from positive blood cultures.…”

Section: Syndromic Testingmentioning

confidence: 99%

A New Age in Molecular Diagnostics for Invasive Fungal Disease: Are We Ready?

et al. 2020

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“…(Guerendiain et al, 2016) These microarray technologies are able to identify pathogens 24 hours earlier than the conventional culture-based approach because it bypasses the sub-culture. (Bork et al, 2015;Huang et al, 2019) While the traditional high-density microarray remains expensive, the low-density microarray that targets a relatively small number of pathogens has a reasonable price tag for clinical diagnostics. In theory, the microarray has a high degree of multiplexing capability.…”

Section: Microarray-microarraymentioning

confidence: 99%

A ‘culture’ shift: Application of molecular techniques for diagnosing polymicrobial infections

Zhang

Andini

et al. 2019

Biotechnology Advances

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With the advancement of microbiological discovery, it is evident that many infections, particularly bloodstream infections, are polymicrobial in nature. Consequently, new challenges have emerged in identifying the numerous etiologic organisms in an accurate and timely manner using the current diagnostic standard. Various molecular diagnostic methods have been utilized as an effort to provide a fast and reliable identification in lieu or parallel to the conventional culture-based methods. These technologies are mostly based on nucleic acid, proteins, or physical properties of the pathogens with differing advantages and limitations. This review evaluates the different molecular methods and technologies currently available to diagnose polymicrobial infections, which will help determine the most appropriate option for future diagnosis.

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Evaluation of the ePlex Blood Culture Identification Panels for Detection of Pathogens in Bloodstream Infections

Cited by 64 publications

References 24 publications

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

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

A New Age in Molecular Diagnostics for Invasive Fungal Disease: Are We Ready?

A ‘culture’ shift: Application of molecular techniques for diagnosing polymicrobial infections

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