■用于阳性血液培养的快速诊断平台的可用性加快了临床微生物学实验室能够识别致病微生物并促进早期适当的抗菌治疗的速度。关于血液培养鉴定2(BCID2)小组测试的临床实用性及其与来自重症监护病房(ICU)的标记血液培养瓶(DST)的表型药物敏感性测试(DST)的相关性的数据很少,例如印度,其中多药耐药革兰氏阴性菌(MDR-GNB)的发生率很高。
■我们在三级护理ICU中对200名18岁以上的患者进行了回顾性观察研究,其中当血液培养标记为阳性时,要求进行BCID2测试。
■我们发现在细菌和酵母的鉴定中,BCID2和培养物之间有99%的一致性,在表型和基因型DST之间有96.5%的一致性。此外,BCID2比常规ID和DST早1.5天,在82.5%的患者中发挥了关键作用。根据BCID2报告,138例患者(69%)在经验性剂量后更早停止了基于多粘菌素的治疗。
■在单一抗菌菌血症的危重患者中,BCID2可快速鉴定细菌和抗菌素耐药性(AMR)基因,并且比常规培养和敏感性测试明显更快。在同一天,超过三分之一的患者出现了抗生素升级,近五分之一的患者出现了抗生素降级。我们建议所有ICU在其抗生素决策过程和抗菌药物管理中常规纳入该测试。
■VineethVK,NambiPS,GopalakrishnanR,SethuramanN,RamanathanY,ChandranC,etal.来自三级护理医院的重症监护病房的标记的血培养样品中的血培养鉴定2面板的临床效用。印度J暴击护理中心2024;28(5):461-466。
UNASSIGNED: The availability of rapid diagnostic platforms for positive blood cultures has accelerated the speed at which the clinical microbiology laboratory can identify the causative organism and facilitate early appropriate antimicrobial therapy. There is a paucity of data regarding the clinical utility of the blood culture identification 2 (BCID2) panel test and its correlation with phenotypic drug susceptibility testing (DST) in flagged blood culture bottles from intensive care units (ICUs) in countries such as India, which have high rates of multidrug-resistant gram-negative bacteria (MDR-GNB).
UNASSIGNED: We conducted a retrospective observational study in a tertiary care ICU on 200 patients above 18 years of age in whom a BCID2 test was ordered when blood cultures flagged positive.
UNASSIGNED: We found 99% concordance between BCID2 and cultures in the identification of bacteria and yeasts and 96.5% concordance between phenotypic and genotypic DST. Furthermore, BCID2 was available about 1.5 days earlier than conventional ID and DST and played a key role in tailoring antimicrobials in 82.5% of the patients.
Polymyxin-based therapy was discontinued earlier after an empiric dose in 138 patients (69%) based on BCID2 reports.
UNASSIGNED: In critically ill patients with monomicrobial bacteremia, BCID2 rapidly identifies bacteria and antimicrobial resistance (AMR) genes and is significantly faster than conventional culture and sensitivity testing. Antibiotics were escalated in more than a third of patients and de-escalated in almost a fifth on the same day. We recommend that all ICUs routinely incorporate the test in their antibiotic decision-making process and in antimicrobial stewardship.
UNASSIGNED: Vineeth VK, Nambi PS, Gopalakrishnan R, Sethuraman N, Ramanathan Y, Chandran C, et al. Clinical Utility of Blood Culture Identification 2 Panel in Flagged Blood Culture Samples from the Intensive Care Unit of a Tertiary Care Hospital. Indian J Crit Care Med 2024;28(5):461-466.