1887

Abstract

Utilization of commercially available rapid platforms for microbial identification from positive blood cultures is useful during periods of, or in laboratories with, limited expert staffing. We compared the results of the FilmArray BCID Panel performed by non-expert technologists to those of conventional methods for organism identification performed by skilled microbiologists. Within 8 h of signalling positive by a continuous monitoring blood culture system, positive bottles were analysed by the FilmArray BCID Panel. Data from these analyses were compared to standard-of-care testing, which included conventional and automated methods. To gauge the ease of use of the BCID Panel by non-expert staff, technologists unfamiliar with diagnostic bacteriology performed the testing without prior knowledge of the Gram stain results, or even whether organisms were detected. Identifications of 172/200 (86 %) positive blood cultures using the BCID Panel were consistent with identifications provided by standard-of-care methods. Standard-of-care testing identified organisms in 20 positive blood cultures, which were not represented on the BCID Panel. Seven (3.5 %) blood cultures demonstrated a discrepancy between the methods, which could not be attributed to either a lack of representation on the panel or unclear separate detection of organisms in a mixed blood culture of a shared genus or grouping of organisms, e.g. or . One (0.5 %) blood culture yielded invalid results on two separate panels, so it was eliminated from the study. The easy-to-use FilmArray technology shows good correlation with blood culture identification and antibiotic resistance detection performed by conventional methods. This technology may be particularly useful in laboratories with limited staffing or limited technical expertise.

Keyword(s): Blood culture , multiplex and sepsis
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/content/journal/jmm/10.1099/jmm.0.000277
2016-07-01
2019-12-13
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References

  1. Altun O., Almuhayawi M., Ullberg M., Ozenci V.. 2013; Clinical evaluation of the FilmArray blood culture identification panel in identification of bacteria and yeasts from positive blood culture bottles. J Clin Microbiol51:4130–4136 [CrossRef][PubMed]
    [Google Scholar]
  2. Barenfanger J., Graham D. R., Kolluri L., Sangwan G., Lawhorn J., Drake C. A., Verhulst S. J., Peterson R., Moja L. B. et al. 2008; Decreased mortality associated with prompt Gram staining of blood cultures. Am J Clin Pathol130:870–876 [CrossRef][PubMed]
    [Google Scholar]
  3. Beekmann S. E., Diekema D. J., Chapin K. C., Doern G. V.. 2003; Effects of rapid detection of bloodstream infections on length of hospitalization and hospital charges. J Clin Microbiol41:3119–3125 [CrossRef][PubMed]
    [Google Scholar]
  4. BioFire Diagnostics, Inc 510(k) Number: k130914 [20 March 2016]http://www.accessdata.fda.gov/cdrh_docs/reviews/K130914.pdf
  5. Blaschke A. J., Heyrend C., Byington C. L., Fisher M. A., Barker E., Garrone N. F., Thatcher S. A., Pavia A. T., Barney T. et al. 2012; Rapid identification of pathogens from positive blood cultures by multiplex polymerase chain reaction using the FilmArray system. Diagn Microbiol Infect Dis74:349–355 [CrossRef][PubMed]
    [Google Scholar]
  6. Buchan B. W., Ginocchio C. C., Manii R., Cavagnolo R., Pancholi P., Swyers L., Thomson R. B., Anderson C., Kaul K. et al. 2013; Multiplex identification of gram-positive bacteria and resistance determinants directly from positive blood culture broths: evaluation of an automated microarray-based nucleic acid test. PLoS Med10:e1001478 [CrossRef][PubMed]
    [Google Scholar]
  7. Croxatto A., Prod'hom G., Greub G.. 2012; Applications of MALDI-TOF mass spectrometry in clinical diagnostic microbiology. FEMS Microbiol Rev36:380–407 [CrossRef][PubMed]
    [Google Scholar]
  8. Doern G. V., Vautour R., Gaudet M., Levy B.. 1994; Clinical impact of rapid in vitro susceptibility testing and bacterial identification. J Clin Microbiol32:1757–1762[PubMed]
    [Google Scholar]
  9. Idelevich E. A., Schüle I., Grünastel B., Wüllenweber J., Peters G., Becker K.. 2014; Rapid identification of microorganisms from positive blood cultures by MALDI-TOF mass spectrometry subsequent to very short-term incubation on solid medium. Clin Microbiol Infect20:1001–1006 [CrossRef][PubMed]
    [Google Scholar]
  10. Kothari A., Morgan M., Haake D. A.. 2014; Emerging technologies for rapid identification of bloodstream pathogens. Clin Infect Dis59:272–278 [CrossRef][PubMed]
    [Google Scholar]
  11. Lagacé-Wiens P. R., Adam H. J., Karlowsky J. A., Nichol K. A., Pang P. F., Guenther J., Webb A. A., Miller C., Alfa M. J.. 2012; Identification of blood culture isolates directly from positive blood cultures by use of matrix-assisted laser desorption ionization-time of flight mass spectrometry and a commercial extraction system: analysis of performance, cost, and turnaround time. J Clin Microbiol50:3324–3328 [CrossRef][PubMed]
    [Google Scholar]
  12. Oliveira K., Procop G. W., Wilson D., Coull J., Stender H.. 2002; Rapid identification of Staphylococcus aureus directly from blood cultures by fluorescence in situ hybridization with peptide nucleic acid probes. J Clin Microbiol40:247–251 [CrossRef][PubMed]
    [Google Scholar]
  13. Paolucci M., Landini M. P., Sambri V.. 2010; Conventional and molecular techniques for the early diagnosis of bacteraemia. Int J Antimicrob Agents36:S6–16 [CrossRef][PubMed]
    [Google Scholar]
  14. Perez K. K., Olsen R. J., Musick W. L., Cernoch P. L., Davis J. R., Land G. A., Peterson L. E., Musser J. M.. 2013; Integrating rapid pathogen identification and antimicrobial stewardship significantly decreases hospital costs. Arch Pathol Lab Med137:1247–1254 [CrossRef][PubMed]
    [Google Scholar]
  15. Southern T. R., VanSchooneveld T. C., Bannister D. L., Brown T. L., Crismon A. S., Buss S. N., Iwen P. C., Fey P. D.. 2015; Implementation and performance of the BioFire FilmArray® Blood Culture Identification panel with antimicrobial treatment recommendations for bloodstream infections at a midwestern academic tertiary hospital. Diagn Microbiol Infect Dis81:96–101 [CrossRef][PubMed]
    [Google Scholar]
  16. Verroken A., Defourny L., Lechgar L., Magnette A., Delmée M., Glupczynski Y.. 2015; Reducing time to identification of positive blood cultures with MALDI-TOF MS analysis after a 5-h subculture. Eur J Clin Microbiol Infect Dis34:405–413 [CrossRef][PubMed]
    [Google Scholar]
  17. Wolk D. M., Struelens M. J., Pancholi P., Davis T., Della-Latta P., Fuller D., Picton E., Dickenson R., Denis O. et al. 2009; Rapid detection of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) in wound specimens and blood cultures: multicenter preclinical evaluation of the Cepheid Xpert MRSA/SA skin and soft tissue and blood culture assays. J Clin Microbiol47:823–826 [CrossRef][PubMed]
    [Google Scholar]
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