Micó Miquel, Navarro Ferran, de Miniac Daniela, González Yésica, Brell Albert, López Cristina, Sánchez-Reus Ferran, Mirelis Beatriz, Coll Pere
Servei de Microbiologia. Hospital de la Santa Creu i Sant Pau Barcelona, Spain.
Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain.
J Med Microbiol. 2015 Dec;64(12):1481-1488. doi: 10.1099/jmm.0.000180. Epub 2015 Oct 1.
Molecular-based techniques reduce the delay in diagnosing infectious diseases and therefore contribute to better patient outcomes. We assessed the FilmArray blood culture identification (BCID) panel (Biofire Diagnostics/bioMérieux) directly on clinical specimens other than blood: cerebrospinal, joint, pleural and ascitic fluids, bronchoscopy samples and abscesses. We compared the results from 88 samples obtained by culture-based techniques. The percentage of agreement between the two methods was 75 % with a Cohen κ value of 0.51. Global sensitivity and specificity using the FilmArray BCID panel were 71 and 97 %, respectively. Sensitivity was poorer in samples with a low bacterial load, such as ascitic and pleural fluids (25 %), whereas the sensitivity for abscess samples was high (89 %). These findings suggest that the FilmArray BCID panel could be useful to perform microbiological diagnosis directly from samples other than positive blood cultures, as it offers acceptable sensitivity and moderate agreement with conventional microbiological methods. Nevertheless, cost-benefit studies should be performed before introducing this method into algorithms for microbiological diagnostics.
基于分子的技术减少了传染病诊断的延迟,因此有助于改善患者预后。我们直接在血液以外的临床标本上评估了FilmArray血培养鉴定(BCID)检测板(Biofire Diagnostics/生物梅里埃公司):脑脊液、关节液、胸水和腹水、支气管镜检查样本以及脓肿。我们比较了通过基于培养的技术获得的88份样本的结果。两种方法之间的一致性百分比为75%,科恩κ值为0.51。使用FilmArray BCID检测板的总体敏感性和特异性分别为71%和97%。在细菌载量低的样本中,如腹水和胸水,敏感性较差(25%),而脓肿样本的敏感性较高(89%)。这些发现表明,FilmArray BCID检测板可用于直接从阳性血培养以外的样本进行微生物诊断,因为它具有可接受的敏感性,并且与传统微生物学方法有适度的一致性。然而,在将该方法引入微生物诊断算法之前,应进行成本效益研究。