Division of Hospital Medicine, Department of Internal Medicine, UC Davis Medical Center, Sacramento, CA, USA.
Department of Pharmacy, UC Davis Medical Center, Sacramento, CA, USA.
Diagn Microbiol Infect Dis. 2023 Dec;107(4):116086. doi: 10.1016/j.diagmicrobio.2023.116086. Epub 2023 Sep 13.
The rapid multiplex PCR (rmPCR)-based FilmArray® blood culture identification (BCID) assay reduces time from positive blood culture to organism identification. Polymicrobial bacteremia (PMB) is a known area of reduced diagnostic fidelity for BCID and remains incompletely characterized. All cases of clinically confirmed PMB at a large academic single center from a 23-month period were evaluated in a retrospective cohort analysis. A total of 207 samples were identified and studied. Overall, 49.3% (N = 102) of polymicrobial cultures were incompletely identified by FilmArray® result. There were no significant between-group differences in comorbidity status, length of stay, mortality, or source between patients with PMB who had complete versus incomplete BCID identification. Our results suggest that rmPCR-based assays frequently miss organisms in PMB and should be interpreted accordingly.
基于快速多重聚合酶链反应(rmPCR)的 FilmArray®血培养鉴定(BCID)检测可减少从血培养阳性到鉴定病原体所需的时间。多微生物菌血症(PMB)是 BCID 诊断准确性降低的一个已知领域,其特征仍不完全清楚。对 23 个月内一家大型学术性单一中心临床确诊的 PMB 所有病例进行了回顾性队列分析。共鉴定和研究了 207 个样本。总体而言,102 例(49.3%)多微生物培养物的 FilmArray®结果不完全鉴定。PMB 患者的合并症状态、住院时间、死亡率或来源在完全与不完全 BCID 鉴定之间无显著差异。我们的结果表明,基于 rmPCR 的检测方法经常漏检 PMB 中的病原体,应相应解读结果。