Abstract：
BACKGROUND: The increasing prevalence of drug-resistant pathogens leads to delays in adequate antimicrobial treatment in intensive care units (ICU). The real-world influence of the BioFire FilmArray Blood Culture Identification 2 (BCID2) panel on pathogen identification, diagnostic concordance with conventional culture methods, and antimicrobial stewardship in the ICU remains unexplored.
METHODS: This retrospective observational study, conducted from July 2021 to August 2023, involved adult ICU patients with positive blood cultures who underwent BCID2 testing. The concordance between BCID2 and conventional culture results was examined, and its impact on antimicrobial stewardship was assessed through a comprehensive retrospective review of patient records by intensivists.
RESULTS: A total of 129 blood specimens from 113 patients were analysed. Among these patients, a high proportion of drug-resistant strains were noted, including carbapenem-resistant Klebsiella pneumoniae (CRKP) (57.1%), carbapenem-resistant Acinetobacter calcoaceticus-baumannii complex (100%), methicillin-resistant Staphylococcus aureus (MRSA) (70%), and vancomycin-resistant Enterococcus faecium (VRE) (100%). The time from blood culture collection to obtaining BCID2 results was significantly shorter than conventional culture (46.2 h vs. 86.9 h, p < 0.001). BCID2 demonstrated 100% concordance in genotype-phenotype correlation in antimicrobial resistance (AMR) for CRKP, carbapenem-resistant Escherichia coli, MRSA, and VRE. A total of 40.5% of patients received inadequate empirical antimicrobial treatment. The antimicrobial regimen was adjusted or confirmed in 55.4% of patients following the BCID2 results.
CONCLUSIONS: In the context of a high burden of drug-resistant pathogens, BCID2 demonstrated rapid pathogen and AMR detection, with a noticeable impact on antimicrobial stewardship in BSI in the ICU.
METHODS: This retrospective observational study, conducted from July 2021 to August 2023, involved adult ICU patients with positive blood cultures who underwent BCID2 testing. The concordance between BCID2 and conventional culture results was examined, and its impact on antimicrobial stewardship was assessed through a comprehensive retrospective review of patient records by intensivists.
RESULTS: A total of 129 blood specimens from 113 patients were analysed. Among these patients, a high proportion of drug-resistant strains were noted, including carbapenem-resistant Klebsiella pneumoniae (CRKP) (57.1%), carbapenem-resistant Acinetobacter calcoaceticus-baumannii complex (100%), methicillin-resistant Staphylococcus aureus (MRSA) (70%), and vancomycin-resistant Enterococcus faecium (VRE) (100%). The time from blood culture collection to obtaining BCID2 results was significantly shorter than conventional culture (46.2 h vs. 86.9 h, p < 0.001). BCID2 demonstrated 100% concordance in genotype-phenotype correlation in antimicrobial resistance (AMR) for CRKP, carbapenem-resistant Escherichia coli, MRSA, and VRE. A total of 40.5% of patients received inadequate empirical antimicrobial treatment. The antimicrobial regimen was adjusted or confirmed in 55.4% of patients following the BCID2 results.
CONCLUSIONS: In the context of a high burden of drug-resistant pathogens, BCID2 demonstrated rapid pathogen and AMR detection, with a noticeable impact on antimicrobial stewardship in BSI in the ICU.
摘要：
背景：耐药病原体的流行增加导致重症监护病房（ICU）中适当的抗菌治疗延迟。BioFireFilmArray血液培养鉴定2（BCID2）面板对病原体鉴定的现实影响，与常规培养方法的诊断一致性，ICU中的抗菌药物管理仍未探索。
方法：这项回顾性观察研究，本研究于2021年7月至2023年8月进行,涉及接受BCID2检测的血培养阳性的成年ICU患者.检查了BCID2和常规培养结果之间的一致性，其对抗菌药物管理的影响通过重症医师对患者记录的全面回顾性审查进行评估.
结果：共分析了来自113例患者的129份血液样本。在这些患者中,注意到高比例的耐药菌株，包括耐碳青霉烯类肺炎克雷伯菌（CRKP）（57.1%），耐碳青霉烯的钙乙酸鲍曼不动杆菌复合物（100％），耐甲氧西林金黄色葡萄球菌(MRSA)(70%),耐万古霉素屎肠球菌(VRE)(100%)。从血液培养收集到获得BCID2结果的时间明显短于常规培养（46.2hvs.86.9h,p<0.001)。BCID2在CRKP的抗菌素耐药性（AMR）的基因型-表型相关性中表现出100％的一致性，耐碳青霉烯大肠杆菌,MRSA,和VRE。共有40.5%的患者接受经验性抗菌治疗不充分。在BCID2结果后，55.4%的患者调整或确认了抗菌方案。
结论：在耐药病原体高负担的背景下，BCID2显示了快速病原体和AMR检测，对ICUBSI抗菌药物管理有显著影响。
方法：这项回顾性观察研究，本研究于2021年7月至2023年8月进行,涉及接受BCID2检测的血培养阳性的成年ICU患者.检查了BCID2和常规培养结果之间的一致性，其对抗菌药物管理的影响通过重症医师对患者记录的全面回顾性审查进行评估.
结果：共分析了来自113例患者的129份血液样本。在这些患者中,注意到高比例的耐药菌株，包括耐碳青霉烯类肺炎克雷伯菌（CRKP）（57.1%），耐碳青霉烯的钙乙酸鲍曼不动杆菌复合物（100％），耐甲氧西林金黄色葡萄球菌(MRSA)(70%),耐万古霉素屎肠球菌(VRE)(100%)。从血液培养收集到获得BCID2结果的时间明显短于常规培养（46.2hvs.86.9h,p<0.001)。BCID2在CRKP的抗菌素耐药性（AMR）的基因型-表型相关性中表现出100％的一致性，耐碳青霉烯大肠杆菌,MRSA,和VRE。共有40.5%的患者接受经验性抗菌治疗不充分。在BCID2结果后，55.4%的患者调整或确认了抗菌方案。
结论：在耐药病原体高负担的背景下，BCID2显示了快速病原体和AMR检测，对ICUBSI抗菌药物管理有显著影响。
