Kuzawka Marilina, Cassanelli Martín, Capecce Fabrina, Pereda Rosana
Hospital General de Niños «Pedro de Elizalde», Buenos Aires, Argentina.
Hospital General de Niños «Pedro de Elizalde», Buenos Aires, Argentina.
Rev Argent Microbiol. 2024 Jul-Sep;56(3):249-257. doi: 10.1016/j.ram.2023.07.007. Epub 2024 Jul 29.
The rapid identification of microorganisms that cause bacteremia and their possible resistance markers are extremely important for the timely initiation of effective antibiotic therapy. The FilmArray® panel BCID2 (an automated rapid multiplex PCR assay) detects microorganisms and resistance genes from positive blood cultures within one hour. The aim of this study was to compare the results obtained from the FilmArray® Panel BCID2 and conventional culture in pediatric patients, as well as the reporting times of both methods. Sixty (60) FilmArray® results were included in the analysis. BCID2 showed high agreement with culture in the identification of microorganisms in monomicrobial bacteremias. However, in polymicrobial blood cultures, BCID2 detected a greater number of microorganisms compared to conventional culture, specifically,1 Staphylococcus aureus, 3 Staphylococcus epidermidis, 1 Enterococcus faecium, 2 Klebsiella oxytoca, 1 Acinetobacter calcoaceticus-baumannii complex, 1 Bacteroides fragilis and 1 Haemophilus influenzae. Furthermore, 88.3% (95%CI: 78.7-94.8) of the FilmArray® results coincided with conventional culture, while in polymicrobial bacteremias, BCID2 detected a greater number of microorganisms with respect to conventional culture [70% (95%CI: 39.3-91.5)]. The agreement of resistance genes was good with a few exceptions (one ESBL was not detected by FilmArray® and one S. aureus strain was characterized as methicillin-resistant by BCID2 and methicillin-sensitive by culture). When comparing the time elapsing since the blood culture was reported as positive up to the results were obtained, BCID2 had a median of 2h 50min (IQR of 1 h 58min to 9h 27min) while the conventional culture had a median of 45h 20min (IQR of 24h 57min to 63h 50min).
快速鉴定引起菌血症的微生物及其可能的耐药标志物对于及时启动有效的抗生素治疗极为重要。FilmArray® BCID2检测板（一种自动化快速多重PCR检测方法）可在一小时内从阳性血培养物中检测微生物和耐药基因。本研究的目的是比较FilmArray® BCID2检测板与传统培养方法在儿科患者中的检测结果，以及两种方法的报告时间。分析纳入了60份FilmArray®检测结果。BCID2在单微生物菌血症的微生物鉴定方面与传统培养方法具有高度一致性。然而，在多微生物血培养中，与传统培养方法相比，BCID2检测到的微生物数量更多，具体为1株金黄色葡萄球菌、3株表皮葡萄球菌、1株粪肠球菌、2株产酸克雷伯菌、1株醋酸钙不动杆菌-鲍曼不动杆菌复合群、1株脆弱拟杆菌和1株流感嗜血杆菌。此外，88.3%（95%CI：78.7 - 94.8）的FilmArray®检测结果与传统培养方法一致，而在多微生物菌血症中，相对于传统培养方法，BCID2检测到的微生物数量更多[70%（95%CI：39.3 - 91.5）]。耐药基因的一致性良好，仅有少数例外（一种超广谱β-内酰胺酶未被FilmArray®检测到，一株金黄色葡萄球菌菌株被BCID2鉴定为耐甲氧西林，而传统培养方法鉴定为甲氧西林敏感）。比较从血培养报告为阳性到获得结果所经过的时间，BCID2的中位数为2小时50分钟（四分位间距为1小时58分钟至9小时27分钟），而传统培养方法的中位数为45小时20分钟（四分位间距为24小时57分钟至63小时50分钟）。
