Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
J Microbiol Immunol Infect. 2020 Dec;53(6):882-891. doi: 10.1016/j.jmii.2020.03.018. Epub 2020 Apr 2.
BACKGROUND/PURPOSE: Rapid and accurate identification of pathogens and their antibiotic resistance directly from flagged blood cultures can aid clinicians in optimizing early antibiotic treatment and improve the clinical outcomes, especially in settings associated with high rates of bloodstream infection caused by vancomycin-resistant Enterococci (VRE) and carbapenem-resistant Enterobacteriaceae (CRE). We compared the results of the BioFire FilmArray Blood Culture Identification (BCID) panel with those of conventional methods for identifying the pathogens and their antibiotic susceptibility status.
In total, 100 randomly selected positive blood cultures (BACTEC Plus Aerobic/F bottles or BACTEC Anaerobic Lytic/10 bottles) were analyzed. The pathogen detection efficiency of FilmArray BCID panel was compared with that of conventional method using MALDI-TOF MS system (Bruker MALDI Biotyper) and susceptibility testing by the Vitek 2 system. The sequencing analysis of antibiotic resistance genes was performed for discrepant results obtained from MALDI Biotyper and Vitek 2.
Among the 100 positively flagged blood cultures, 94% of FilmArray BCID panel results were consistent with the MALDI Biotyper results. All five VRE isolates positive for vanA/vanB genes, 10 of 12 Staphylococcus species positive for mecA gene, and only one Klebsiella pneumoniae isolate positive for K. pneumoniae carbapenemase gene (bla) detected in the FilmArray BCID panel were also concordant with results by the results by conventional susceptibility testing/molecular confirmation.
The FilmArray BCID panel results not only demonstrated good correlation with conventional blood culture identification and susceptibility results but also provided results rapidly, especially for the early detection of MRSA, VRE and bla-mediated CRE.
背景/目的：从标记的血培养物中快速准确地鉴定病原体及其抗生素耐药性，可以帮助临床医生优化早期抗生素治疗，并改善临床结局，尤其是在血流感染率高的情况下，这些感染是由耐万古霉素肠球菌（VRE）和耐碳青霉烯肠杆菌科（CRE）引起的。我们比较了 BioFire FilmArray 血培养鉴定（BCID）面板与传统方法鉴定病原体及其抗生素敏感性的结果。
共分析了 100 份随机选择的阳性血培养物（BACTEC Plus 需氧/F 瓶或 BACTEC 厌氧裂解/10 瓶）。使用 MALDI-TOF MS 系统（布鲁克 MALDI Biotyper）和 Vitek 2 系统进行药敏试验，比较 FilmArray BCID 面板与传统方法对病原体检测效率的差异。对 MALDI Biotyper 和 Vitek 2 结果不一致的抗生素耐药基因进行测序分析。
在 100 份阳性标记血培养物中，94%的 FilmArray BCID 面板结果与 MALDI Biotyper 结果一致。所有五个携带 vanA/vanB 基因的 VRE 分离株、12 个 mecA 基因阳性的葡萄球菌属中 10 个以及仅一个携带 K. pneumoniae 碳青霉烯酶基因（bla）的肺炎克雷伯菌分离株，在 FilmArray BCID 面板中的检测结果与传统药敏试验/分子确认的结果一致。
FilmArray BCID 面板的结果不仅与传统血培养鉴定和药敏结果具有良好的相关性，而且还能快速提供结果，特别是对于早期检测 MRSA、VRE 和 bla 介导的 CRE。
