Senok Abiola, Dabal Laila Al, Alfaresi Mubarak, Habous Maya, Celiloglu Handan, Bashiri Safia, Almaazmi Naama, Ahmed Hassan, Mohmed Ayman A, Bahaaldin Omar, Elimam Maimona Ahmed Elsiddig, Rizvi Irfan Hussain, Olowoyeye Victory, Powell Michaela, Salama Basel
College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates.
Infectious Diseases Unit, Rashid Hospital, Dubai P.O. Box 4545, United Arab Emirates.
Diagnostics (Basel). 2023 Jul 21;13(14):2433. doi: 10.3390/diagnostics13142433.
Rapid pathogen identification is key to the proper management of patients with bloodstream infections (BSIs), especially in the intensive care setting. This multicentre study compared the time to pathogen identification results in 185 patients admitted to intensive care with a confirmed BSI, using conventional methods ( = 99 patients) and upon implementation of the BIOFIRE Blood Culture Identification 2 (BCID2) Panel, a rapid molecular test allowing for the simultaneous identification of 43 BSI-related nucleic acids targets ( = 86 patients). The median time to result informing optimal antibiotic therapy was significantly shorter following the implementation of the BCID2 Panel (92 vs. 28 h pre vs. post BCID2 implementation; < 0.0001). BCID2 usage in addition to conventional methods led to the identification of at least one pathogen in 98.8% patients vs. 87.9% using conventional methods alone ( = 0.003) and was associated with a lower 30-day mortality (17.3% vs. 31.6%, respectively; = 0.019). This study at three intensive care units in the United Arab Emirates therefore demonstrates that, in addition to conventional microbiological methods and an effective antimicrobial stewardship program, the BCID2 Panel could improve the clinical outcome of patients admitted to the intensive care unit with a confirmed BSI.
快速鉴定病原体是正确管理血流感染(BSI)患者的关键,尤其是在重症监护环境中。这项多中心研究比较了185例确诊为BSI的重症监护患者使用传统方法(n = 99例患者)和实施BIOFIRE血培养鉴定2(BCID2)检测板(一种可同时鉴定43种与BSI相关核酸靶点的快速分子检测方法,n = 86例患者)后获得病原体鉴定结果的时间。实施BCID2检测板后,为优化抗生素治疗提供结果通知的中位时间显著缩短(BCID2实施前为92小时,实施后为28小时;P < 0.0001)。除传统方法外使用BCID2,98.8%的患者至少鉴定出一种病原体,而仅使用传统方法时这一比例为87.9%(P = 0.003),且与较低的30天死亡率相关(分别为17.3%和31.6%;P = 0.019)。因此,在阿拉伯联合酋长国三个重症监护病房进行的这项研究表明,除了传统微生物学方法和有效的抗菌药物管理计划外,BCID2检测板可改善确诊为BSI的重症监护病房患者的临床结局。