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评估BioFire FilmArray巢式多重聚合酶链反应方法对脓毒症中快速病原体鉴定及抗菌药物管理的效果。

Evaluation of the effect of BioFire FilmArray nested multiplex polymerase chain reaction method on rapid pathogen identification and antimicrobial stewardship in sepsis.

作者信息

Kış Tuba Tatlı, Biçmen Can, Yıldırım Suleyman, Ediboğlu Ozlem, Yıldız Fatma Sebnem, Gunduz Ayriz Tuba, Demirci Ferhat, Kıraklı Cenk

机构信息

Health Sciences University, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, Department of Clinical Microbiology and Infectious Diseases - İzmir, Turkey.

Health Sciences University, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, Department of Microbiology - İzmir, Turkey.

出版信息

Rev Assoc Med Bras (1992). 2024 Dec 16;70(12):e20241038. doi: 10.1590/1806-9282.20241038. eCollection 2024.

Abstract

OBJECTIVE

In this study, we aimed to assess the effect of the BioFire FilmArray Blood Culture Identification 2 panel on agent identification and antimicrobial stewardship in patients with a critical state of sepsis secondary to bloodstream infection.

METHODS

This study was designed as a prospective observational study. Patients who developed sepsis and septic shock secondary to bloodstream infection in the intensive care unit were included in the study. Concordance in both monomicrobial and polymicrobial results of Blood Culture Identification 2 panel and conventional blood culture, test result times, and antibiotherapy changes according to Blood Culture Identification 2 panel results were evaluated.

RESULTS

In monomicrobial samples, sensitivity and specificity were 97.1% (95%CI 84.6-99.3) and 100% (95%CI 66.3-100), respectively, for gram-negative pathogens and 85.7% (95%CI 42.1-99.6) and 100% (95%CI 90.2-100), respectively, for gram-positive pathogens. In polymicrobial samples, Blood Culture Identification 2 panel results were 79% in concordance with conventional blood culture results. In this study, when the final turnaround time of the Blood Culture Identification 2 panel was compared with culture results, the Blood Culture Identification 2 panel was on average 1 day, 5 h, and 35 min faster than the culture (p<0.01).

CONCLUSION

Blood Culture Identification 2 testing is a reliable tool for rapid pathogen and antimicrobial susceptibility detection in critically ill sepsis patients. The use of the Blood Culture Identification 2 panel in patients with sepsis and/or septic shock, where the transition to targeted antibiotherapy is critical, may improve patient outcomes.

摘要

目的

在本研究中,我们旨在评估BioFire FilmArray血培养鉴定2检测板对血流感染继发严重脓毒症患者的病原体鉴定及抗菌药物管理的影响。

方法

本研究设计为前瞻性观察性研究。纳入在重症监护病房因血流感染继发脓毒症和脓毒性休克的患者。评估血培养鉴定2检测板与传统血培养在单微生物和多微生物结果方面的一致性、检测结果时间,以及根据血培养鉴定2检测板结果进行的抗菌治疗变化。

结果

在单微生物样本中,对于革兰氏阴性病原体,血培养鉴定2检测板的敏感性和特异性分别为97.1%(95%CI 84.6 - 99.3)和100%(95%CI 66.3 - 100);对于革兰氏阳性病原体,敏感性和特异性分别为85.7%(95%CI 42.1 - 99.6)和100%(95%CI 90.2 - 100)。在多微生物样本中,血培养鉴定2检测板结果与传统血培养结果的一致性为79%。在本研究中,将血培养鉴定2检测板的最终周转时间与培养结果进行比较时,血培养鉴定2检测板平均比培养快1天5小时35分钟(p<0.01)。

结论

血培养鉴定2检测是危重症脓毒症患者快速病原体检测及抗菌药物敏感性检测的可靠工具。在脓毒症和/或脓毒性休克患者中使用血培养鉴定2检测板,对于向靶向抗菌治疗的转变至关重要,可能改善患者预后。

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