Clinical and laboratory evaluation of the FilmArray BCID panel in blood cultures

Abstract

Background: Sepsis is a major cause of morbidity and mortality in hospital. An accurate and rapid diagnosis of sepsis allows appropriate treatment. The FilmArray blood culture identification (FA-BCID) panel is multiplex PCR-based system. In addition, this system can identify 24 pathogens of sepsis and detect 3 antimicrobial resistance genes in about 1 h. In this study, we evaluated the accuracy and time to identification of the FA-BCID panel as well as compared the clinical efficacy. Methods & Materials: We performed the FA-BCID panel for 60 positive blood cultures. We compared the identification results with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) for agreement and turn around time. We also analyzed the clinical efficacy with quasi experimental study design by comparing before (n = 212) and after (n = 60) implementation of FA-BCID system. Results: FA-BCID detected 94.7% (71/75) of microorganisms identified with MALDI-TOF MS. FA-BCID missed one bacteria and the other three were not included in the panel. Time to identification was significantly different between FA-BCID group (3.6 h) vs. MALDI-TOF group (46.5 h) (P < 0.001). There was no significant difference for 30-day mortality (14.2% vs. 16.7%, P = 0.63), length of stay (11 days vs. 14 days, P = 0.36), and 30-day readmission for infection of the same organism (0.5% vs. 1.7%, P = 0.33) between control and FA-BCID group. Conclusion: The FA-BCID panel provided a rapid and reliable identification result for bloodstream pathogens. This method was effective for therapeutic decision making. Larger number of cases might be needed to confirm the clinical benefit of FA-BCID.