McCoy Morgan H, Relich Ryan F, Davis Thomas E, Schmitt Bryan H
Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
J Med Microbiol. 2016 Jul;65(7):619-625. doi: 10.1099/jmm.0.000277. Epub 2016 May 11.
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. Staphylococcus or Enterobacteriaceae . 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.
在专家人员配备有限的时期或实验室中，使用市售快速平台从阳性血培养物中进行微生物鉴定很有用。我们将非专业技术人员使用FilmArray® BCID检测板的结果与熟练微生物学家使用传统方法进行生物体鉴定的结果进行了比较。在连续监测血培养系统发出阳性信号后的8小时内，对阳性瓶进行FilmArray BCID检测板分析。将这些分析数据与包括传统方法和自动化方法在内的标准护理检测进行比较。为了评估非专业人员使用BCID检测板的难易程度，不熟悉诊断细菌学的技术人员在不知道革兰氏染色结果甚至是否检测到生物体的情况下进行检测。使用BCID检测板对172/200（86%）例阳性血培养物的鉴定结果与标准护理方法提供的鉴定结果一致。标准护理检测在20例阳性血培养物中鉴定出了BCID检测板上未列出的生物体。七例（3.5%）血培养物的两种方法结果存在差异，这既不能归因于检测板上未列出，也不能归因于在混合血培养物中对同一属或生物体组（如葡萄球菌或肠杆菌科）中生物体的单独检测不明确。一例（0.5%）血培养物在两个独立检测板上产生无效结果，因此从研究中剔除。易于使用的FilmArray®技术与传统方法进行的血培养鉴定和抗生素耐药性检测具有良好的相关性。该技术在人员配备有限或技术专业知识有限的实验室中可能特别有用。
