Leitner Eva, Hoenigl Martin, Wagner Bernadette, Krause Robert, Feierl Gebhard, Grisold Andrea J
Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Austria.
Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Austria.
GMS Infect Dis. 2016 Sep 9;4:Doc06. doi: 10.3205/id000024. eCollection 2016.
Sepsis and meningitis are life threatening medical conditions. Culture-based methods are used for identification of the causative pathogens, but they can be improved by implementation of additional test systems. We evaluated the performance of the novel FilmArray blood culture identification (BCID; Biofire Diagnostics) panel for rapid and accurate identification of microorganisms in positive blood cultures and additionally, in this cerebrospinal fluid (CSF) pilot study for direct testing of CSF. A total of 107 positive blood cultures and 20 CSF samples (positive and negative) were investigated and compared to the routine procedures. Of the 107 positive blood cultures, 90.7% (97/107) showed monomicrobial growth and 9.3% (10/107) polymicrobial growth. The FilmArray BCID panel covered 89.3% (25/28) of the bacteria and 100% (2/2) of the yeasts found in this study and accurately identified all of them. From the 20 retrospective analyzed CSF, in 9 positive specimens 6 different bacterial species were identified. Discrepant identification results were found in 25% (5/20) and a low sensitivity of 50% (95% CI of 15.7% to 84.3%) was detected. Our study confirms the FilmArray BCID panel as a rapid, easy to handle PCR system with a good performance in positive blood cultures without Gram-staining result. However, our results additionally suggest that the system is not useful for direct CSF testing due to poor sensitivity.
脓毒症和脑膜炎是危及生命的病症。基于培养的方法用于鉴定致病病原体,但可通过实施额外的检测系统加以改进。我们评估了新型FilmArray血培养鉴定(BCID;Biofire Diagnostics)检测板在阳性血培养中快速准确鉴定微生物的性能,此外,在这项脑脊液(CSF)试点研究中评估了其对脑脊液进行直接检测的性能。共对107份阳性血培养样本和20份脑脊液样本(阳性和阴性)进行了研究,并与常规程序进行比较。在107份阳性血培养样本中,90.7%(97/107)显示为单一微生物生长,9.3%(10/107)为多种微生物生长。本研究中FilmArray BCID检测板涵盖了89.3%(25/28)的细菌和100%(2/2)的酵母,并对其全部进行了准确鉴定。在20份回顾性分析的脑脊液样本中,在9份阳性样本中鉴定出6种不同的细菌。在25%(5/20)的样本中发现了不一致的鉴定结果,检测到的灵敏度较低,为50%(95%置信区间为15.7%至84.3%)。我们的研究证实FilmArray BCID检测板是一种快速、易于操作的PCR系统,在不依赖革兰氏染色结果的阳性血培养中表现良好。然而,我们的结果还表明,由于灵敏度较差,该系统对脑脊液直接检测无用。