Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
J Clin Microbiol. 2023 Jun 20;61(6):e0189122. doi: 10.1128/jcm.01891-22. Epub 2023 May 25.
Diagnostic tools that can rapidly identify and characterize microbes growing in blood cultures are important components of clinical microbiology practice because they help to provide timely information that can be used to optimize patient management. This publication describes the bioMérieux BIOFIRE Blood Culture Identification 2 (BCID2) Panel clinical study that was submitted to the U.S. Food & Drug Administration. Results obtained with the BIOFIRE BCID2 Panel were compared to standard-of-care (SoC) results, sequencing results, PCR results, and reference laboratory antimicrobial susceptibility testing results to evaluate the accuracy of its performance. Results for 1,093 retrospectively and prospectively collected positive blood culture samples were initially enrolled, and 1,074 samples met the study criteria and were included in the final analyses. The BIOFIRE BCID2 Panel demonstrated an overall sensitivity of 98.9% (1,712/1,731) and an overall specificity of 99.6% (33,592/33,711) for Gram-positive bacteria, Gram-negative bacteria and yeast targets which the panel is designed to detect. One hundred eighteen off-panel organisms, which the BIOFIRE BCID2 Panel is not designed to detect, were identified by SoC in 10.6% (114/1,074) of samples. The BIOFIRE BCID2 Panel also demonstrated an overall positive percent agreement (PPA) of 97.9% (325/332) and an overall negative percent agreement (NPA) of 99.9% (2,465/2,767) for antimicrobial resistance determinants which the panel is designed to detect. The presence or absence of resistance markers in correlated closely with phenotypic susceptibility and resistance. We conclude that the BIOFIRE BCID2 Panel produced accurate results in this clinical trial.
用于快速鉴定和特征分析血培养中微生物的诊断工具是临床微生物学实践的重要组成部分,因为它们有助于提供可用于优化患者管理的及时信息。本出版物介绍了向美国食品和药物管理局提交的 bioMérieux BIOFIRE 血培养鉴定 2 (BCID2) 面板临床研究。将 BIOFIRE BCID2 面板的结果与标准护理 (SoC) 结果、测序结果、PCR 结果和参考实验室抗菌药物敏感性测试结果进行比较,以评估其性能的准确性。最初纳入了 1,093 份回顾性和前瞻性采集的阳性血培养样本的结果,1,074 份样本符合研究标准并纳入最终分析。BIOFIRE BCID2 面板对其设计检测的革兰氏阳性菌、革兰氏阴性菌和酵母靶标,总体敏感性为 98.9%(1,712/1,731),总体特异性为 99.6%(33,592/33,711)。SoC 在 10.6%(114/1,074)的样本中鉴定出了 118 种不在面板内的微生物,这些微生物不在 BIOFIRE BCID2 面板的设计检测范围内。BIOFIRE BCID2 面板还对其设计检测的抗菌药物耐药决定因素,表现出了总体阳性符合率 (PPA) 为 97.9%(325/332)和总体阴性符合率 (NPA) 为 99.9%(2,465/2,767)。该面板检测到的耐药标记物的存在与否与表型药敏性和耐药性密切相关。我们得出结论,BIOFIRE BCID2 面板在这项临床试验中得出了准确的结果。