PMID- 34431685
OWN - NLM
STAT- MEDLINE
DCOM- 20220103
LR  - 20220103
IS  - 2165-0497 (Electronic)
IS  - 2165-0497 (Linking)
VI  - 9
IP  - 1
DP  - 2021 Sep 3
TI  - Clinical Impact of the Expanded BioFire Blood Culture Identification 2 Panel in a 
      U.S. Children's Hospital.
PG  - e0042921
LID - 10.1128/Spectrum.00429-21 [doi]
LID - 10.1128/spectrum.00429-21
AB  - The BioFire blood culture identification (BCID) panel decreases time to pathogen 
      identification and time to optimal antimicrobial therapy. The BioFire blood 
      culture identification 2 (BCID2) panel is an expanded panel with 17 additional 
      targets and resistance genes; however, there are limited data on its impact in 
      pediatric patients. We compared the BioFire BCID2 panel and the BCID panel by 
      assaying BCID2 simultaneously with the current standard of care on 191 
      consecutive blood culture specimens at Children's Hospital Colorado. The primary 
      outcome was equivalence, measured as percent agreement between the two panels and 
      standard culture. The theoretical reduction in time to optimal therapy was 
      calculated overall, with subanalyses performed on Enterococcus species and 
      Gram-negative resistance genes. The percent agreement was equivalent between the 
      two panels, with BCID at 98% (95% confidence interval [CI], 95 to 100%) and BCID2 
      at 97% (95% CI, 93 to 99%); the difference was 1.2% (95% CI, -0.8, 3.1%; 
      P < 0.0001). There was not a significant reduction in time to theoretical optimal 
      therapy with BCID2 compared to BCID for all cultures (reduction of 9 h, P = 0.3). 
      Notably, 13 Enterococcus faecalis isolates were detected on BCID2, which would 
      have resulted in a theoretical reduction in time to optimal antimicrobial therapy 
      of 34 h (P = 0.0046). Five CTX-M genes were detected for enteric bacteria. The 
      BioFire BCID2 panel had equal rates of detection compared to the BioFire BCID 
      panel in pediatric patients. It had the advantage of detecting more organisms at 
      the species level, and significantly reducing time to theoretical optimal 
      antimicrobial therapy for Enterococcus faecalis. With the additional resistance 
      genes, it also has the potential to impact care with earlier identification of 
      resistant enteric pathogens. IMPORTANCE The BioFire BCID2 panel is an accurate 
      panel that is equivalent to the BioFire BCID panel compared to standard culture. 
      The BioFire BCID2 panel offers several advantages over the BioFire BCID panel, 
      including enterococcal species identification, Gram-negative resistance gene 
      detection, Salmonella identification, and the added mecA/mecC and SCCmec right 
      extremity junction (MREJ) target for better Staphylococcus aureus and 
      coagulase-negative Staphylococcus (CoNS) differentiation. Most importantly, it 
      provides additional clinical impact with the potential to decrease the time to 
      optimal antimicrobial therapy compared to the BioFire BCID panel, with likely 
      further impact at institutions with a higher prevalence of Gram-negative 
      resistance.
FAU - Graff, Kelly E
AU  - Graff KE
AD  - University of Colorado School of Medicine, Department of Pediatrics, Aurora, 
      Colorado, USA.
FAU - Palmer, Claire
AU  - Palmer C
AD  - University of Colorado School of Medicine, Department of Pediatrics, Aurora, 
      Colorado, USA.
FAU - Anarestani, Toraj
AU  - Anarestani T
AD  - Children's Hospital Colorado, Department of Laboratory and Pathology Medicine, 
      Aurora, Colorado, USA.
FAU - Velasquez, Darcy
AU  - Velasquez D
AD  - Children's Hospital Colorado, Department of Laboratory and Pathology Medicine, 
      Aurora, Colorado, USA.
FAU - Hamilton, Stacey
AU  - Hamilton S
AD  - Children's Hospital Colorado, Department of Laboratory and Pathology Medicine, 
      Aurora, Colorado, USA.
FAU - Pretty, Kristin
AU  - Pretty K
AD  - Children's Hospital Colorado, Department of Laboratory and Pathology Medicine, 
      Aurora, Colorado, USA.
FAU - Parker, Sarah
AU  - Parker S
AD  - University of Colorado School of Medicine, Department of Pediatrics, Aurora, 
      Colorado, USA.
FAU - Dominguez, Samuel R
AU  - Dominguez SR
AUID- ORCID: 0000-0002-6707-5088
AD  - University of Colorado School of Medicine, Department of Pediatrics, Aurora, 
      Colorado, USA.
AD  - Children's Hospital Colorado, Department of Laboratory and Pathology Medicine, 
      Aurora, Colorado, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210825
PL  - United States
TA  - Microbiol Spectr
JT  - Microbiology spectrum
JID - 101634614
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Anti-Infective Agents)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Anti-Infective Agents/therapeutic use
MH  - Bacteria/isolation & purification
MH  - Blood Culture/*methods
MH  - Child
MH  - Child, Preschool
MH  - Drug Resistance, Bacterial/drug effects
MH  - Female
MH  - *Hospitals
MH  - *Hospitals, Pediatric
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - United States
MH  - Young Adult
PMC - PMC8552780
OTO - NOTNLM
OT  - antibiotic resistance
OT  - antimicrobial stewardship
OT  - blood culture
OT  - diagnostics
OT  - multiplex PCR
OT  - pediatrics
EDAT- 2021/08/26 06:00
MHDA- 2022/01/04 06:00
PMCR- 2021/08/25
CRDT- 2021/08/25 12:13
PHST- 2021/08/26 06:00 [pubmed]
PHST- 2022/01/04 06:00 [medline]
PHST- 2021/08/25 12:13 [entrez]
PHST- 2021/08/25 00:00 [pmc-release]
AID - 00429-21 [pii]
AID - 10.1128/Spectrum.00429-21 [doi]
PST - ppublish
SO  - Microbiol Spectr. 2021 Sep 3;9(1):e0042921. doi: 10.1128/Spectrum.00429-21. Epub 
      2021 Aug 25.