Performance of the BioFire Blood Culture Identification 2 Panel for the Diagnosis of Bloodstream Infections on Blood Cultures from the Intensive Care Unit and Emergency Department

2022 ◽  
Author(s):  
Anna Maria Peri ◽  
Michelle J. Bauer ◽  
Haakon Bergh ◽  
Dominika Butkiewicz ◽  
David L. Paterson ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Blood Culture ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Culture Identification

scholarly journals Antimicrobial Stewardship Opportunities in Patients with Bacteremia Not Identified by BioFire FilmArray

2019 ◽  
Vol 57 (5) ◽  
Author(s):  
P. Ny ◽  
A. Ozaki ◽  
J. Pallares ◽  
P. Nieberg ◽  
A. Wong-Beringer
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Culture ◽  
Intensive Care Unit Admission ◽  
Clinical Characteristics ◽  
Length Of Hospital Stay ◽  
Blood Cultures ◽  
Rapid Diagnostics ◽  
Admission Data ◽  
Culture Identification

ABSTRACTA subset of bacteremia cases are caused by organisms not detected by a rapid-diagnostics platform, BioFire blood culture identification (BCID), with unknown clinical characteristics and outcomes. Patients with ≥1 positive blood culture over a 15-month period were grouped by negative (NB-PC) versus positive (PB-PC) BioFire BCID results and compared with respect to demographics, infection characteristics, antibiotic therapy, and outcomes (length of hospital stay [LOS] and in-hospital mortality). Six percent of 1,044 positive blood cultures were NB-PC. The overall mean age was 65 ± 22 years, 54% of the patients were male, and most were admitted from home; fewer NB-PC had diabetes (19% versus 31%,P= 0.0469), although the intensive care unit admission data were similar. Anaerobes were identified in 57% of the bacteremia cases from the NB-PC group by conventional methods:Bacteroidesspp. (30%),Clostridium(11%), andFusobacteriumspp. (8%). Final identification of the NB-PC pathogen was delayed by 2 days (P< 0.01) versus the PB-PC group. The sources of bacteremia were more frequently unknown for the NB-PC group (32% versus 11%,P< 0.01) and of pelvic origin (5% versus 0.1%,P< 0.01) compared to urine (31% versus 9%,P< 0.01) for the PB-PC patients. Fewer NB-PC patients received effective treatment before (68% versus 84%,P= 0.017) and after BCID results (82% versus 96%,P= 0.0048). The median LOS was similar (7 days), but more NB-PC patients died from infection (26% versus 8%,P< 0.01). Our findings affirm the need for the inclusion of anaerobes in BioFire BCID or other rapid diagnostic platforms to facilitate the prompt initiation of effective therapy for bacteremia.

scholarly journals 300. Pediatric Center Evaluation of the BioFire® Blood Culture Identification 2 Panel Versus the Original BioFire®FilmArray® Blood Culture Identification Panel for the Detection of Microorganisms and Resistance Markers in Positive Blood Cultures

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S148-S149
Author(s):  
Kristina B Pierce ◽  
Rebecca Barr ◽  
Aubrie Hopper ◽  
Charlotte Bowerbank ◽  
Anne Shaw ◽  
...  
Keyword(s):  
Blood Culture ◽  
False Negative ◽  
Bloodstream Infections ◽  
Turnaround Time ◽  
Rapid Identification ◽  
Blood Cultures ◽  
Species Level ◽  
Genus Level ◽  
Antimicrobial Resistance Genes ◽  
Culture Identification

Abstract Background Studies show a rising annual incidence of severe sepsis, with bloodstream infections continuing to impact children. Rapid identification of causative agents and timely administration of targeted therapy can positively impact patient outcomes and improve antibiotic stewardship. The BioFire® Blood Culture Identification 2 (BCID2) Panel (BioFire Diagnostics, LLC), an updated version of the FDA-cleared BioFire® FilmArray® Blood Culture Identification (BCID) Panel, designed for use on positive blood cultures (PBCs), assesses 43 analytes, including 17 novel analytes (8 bacterial, 2 fungal, and 7 antimicrobial resistance genes), with a similar turnaround time. Methods De-identified residual PBCs for which clinician-ordered testing per standard of care (SoC) had been performed were enrolled and tested with an Investigation-Use-Only version of the BCID2 Panel. Only one positive bottle per patient was enrolled. Results of BCID2 and BCID were compared. Results 116 PBCs (48 aerobic and 68 anaerobic) were evaluated using the BioFire BCID2 Panel and results were compared to the BioFire BCID Panel. Of the 116 cases, 103 were positive on both the BioFire BCID2 Panel and the BioFire BCID Panel. Ten cases were negative on both tests. While the two panels showed 97% agreement, three cases were discrepant. Using culture (SoC) as the tiebreaker, two cases were false positive and one case was false negative on the BioFire BCID Panel. In all three cases, results from culture and the BioFire BCID2 Panel were in agreement. As expected, no organisms were detected on the BioFire BCID2 Panel in PBCs from 10% (12/116) of PBC bottles where culture identified only organisms that are not part of the panel menu. With the BioFire BCID2 Panel’s expanded platform, two cases identified as Enterobacteriaceae on the BioFire BCID Panel were identified to the genus level on the BioFire BCID2 Panel; 31 cases detected to the genus level on the BioFire BCID Panel were identified to the species level on the BioFire BCID2 Panel. Conclusion Overall, the BioFire BCID2 Panel performed well against the BioFire BCID Panel for identification of bloodstream pathogens and provided additional discrimination of some pathogens to the genus or species level. Data presented are from assays that have not been cleared or approved for diagnostic use. Disclosures All Authors: No reported disclosures

scholarly journals 265. Blood culture results pre- and post- antimicrobial administration in the Medicine Intensive Care Unit: a retrospective study in South Bronx

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S131-S132
Author(s):  
Chia-Yu Chiu ◽  
Amara Sarwal ◽  
Addi Feinstein
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Culture ◽  
Blood Cultures ◽  
Antibiotic Administration ◽  
Culture Result ◽  
Blood Culture Result ◽  
South Bronx ◽  
Coagulase Negative Staphylococci ◽  
Before And After

Abstract Background It is intuitive that obtaining blood cultures prior to administering antibiotics can increase the likelihood of a positive blood culture result. Surviving Sepsis Campaign Hour-1 bundle stipulates that obtaining a blood culture and administering antibiotics within 1 hour is a critical determinant of survival. However, the diagnostic sensitivity shortly after antibiotic administration remains unknown. In clinical practice, some health care providers delay antibiotic administration in order to first obtain a blood culture. Methods Adult patients (&gt; 18 years of age) admitted to the Medicine Intensive Care Unit in Lincoln Medical Center, located in South Bronx, New York City, from 09/2019 to 12/2019. Patients needed to have at least one blood culture obtained within 12 hours of admission and have received intravenous antibiotics during the admission to the Medicine Intensive Care Unit. Results Of 327 patients screened, 196 met enrolment criteria and 253 sets of blood cultures underwent analysis. Blood cultures grew bacteria in 21.8% of pre-antimicrobial group whereas 26.9% in post-antimicrobial group (p=0.37). 25.9% of patients received antibiotics within 1 hour before blood culture sampling, while 34.0% of patients received antibiotics &gt;1 hour prior to obtaining blood culture. Blood culture results positive for coagulase-negative staphylococci were more prevalent in the pre-antimicrobial group. Table 1. Patient Characteristics Table 2. Number of blood cultures obtained and blood culture result Table 3. Initial antimicrobial agent and 30-day mortality Conclusion In the sequence of blood culture and antibiotic administration, there is no 30-day survival difference in pre-antimicrobial group and post-antimicrobial group (p=0.15), as long as both received antibiotics within 12 hours of coming to the hospital. Coagulase-negative staphylococci were higher in the pre-antimicrobial group which may indicate that the health care provider hastily obtained the blood culture in a non-sterile manner. Antibiotic administration should not be delayed because of pending blood culture collection. In addition, given that more than 70% of patients were ultimately found to have negative blood cultures, it would be useful to develop practical tools to identify low-risk patients that can be treated without obtaining blood culture, as the blood culture would not be likely to provide diagnostic information. Figure 1: Hours Before and After IV Antibiotic Started Figure 2: Distribution of Blood Culture Before and After IV Antibiotics Disclosures All Authors: No reported disclosures

scholarly journals The effect of the COVID-19 pandemic on the epidemiology of positive blood cultures in Swiss intensive care units: a nationwide surveillance study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Lauro Damonti ◽  
Andreas Kronenberg ◽  
Jonas Marschall ◽  
Philipp Jent ◽  
Rami Sommerstein ◽  
...  
Keyword(s):  
Intensive Care ◽  
Blood Culture ◽  
Intensive Care Units ◽  
Bloodstream Infections ◽  
Incidence Rates ◽  
Blood Cultures ◽  
Nationwide Surveillance ◽  
The Impact ◽  
Second Wave ◽  
Interim Period

Abstract Background Evidence about the impact of the pandemic of COVID-19 on the incidence rates of blood cultures contaminations and bloodstream infections in intensive care units (ICUs) remains scant. The objective of this study was to investigate the nationwide epidemiology of positive blood cultures drawn in ICUs during the first two pandemic waves of COVID-19 in Switzerland. Methods We analyzed data on positive blood cultures among ICU patients, prospectively collected through a nationwide surveillance system (ANRESIS), from March 30, 2020, to May 31, 2021, a 14-month timeframe that included a first wave of COVID-19, which affected the French and Italian-speaking regions, an interim period (summer 2020) and a second wave that affected the entire country. We used the number of ICU patient-days provided by the Swiss Federal Office of Public Health as denominator to calculate incidence rates of blood culture contaminations and bloodstream infections (ICU-BSI). Incidence rate ratios comparing the interim period with the second wave were determined by segmented Poisson regression models. Results A total of 1099 blood culture contaminations and 1616 ICU-BSIs were identified in 52 ICUs during the study. Overall, more episodes of blood culture contaminations and ICU-BSI were observed during the pandemic waves, compared to the interim period. The proportions of blood culture contaminations and ICU-BSI were positively associated with the ICU occupancy rate, which was higher during the COVID-19 waves. During the more representative second wave (versus interim period), we observed an increased incidence of blood culture contaminations (IRR 1.57, 95% CI 1.16–2.12) and ICU-BSI (IRR 1.20, 95% CI 1.03–1.39). Conclusions An increase in blood culture contaminations and ICU-BSIs was observed during the second COVID-19 pandemic wave, especially in months when the ICU burden of COVID-19 patients was high.

Establishing a Long-Term Model for Analysis and Improvement of Underfilled Blood Culture Volumes

2018 ◽  
Vol 151 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Michael Zaleski ◽  
Patrick Erdman ◽  
Joshua Adams ◽  
Amanda Michael ◽  
Abigail Rudy ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Culture ◽  
False Negative ◽  
Blood Cultures ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Hospital Units ◽  
Time To Detection ◽  
Oncology Unit

Abstract Objectives Underfilling of blood culture bottles decreases the sensitivity of the culture. We attempt to increase average blood culture fill volumes (ABCFVs) through an educational program. Methods Partnerships were established with four hospital units (surgical intensive care unit [SICU], medical intensive care unit [MICU], medical intermediate care unit [MIMCU], and hematology and oncology unit [HEME/ONC]). ABCFVs were continuously tracked and communicated to each unit monthly. Educational sessions were provided to each unit. Results ABCFVs for the SICU, MICU, MIMCU, and HEME/ONC were 4.8, 5.0, 5.0, and 6.3 mL/bottle, respectively. After the final education session, the SICU, MICU, MIMCU, and HEME/ONC were able to maintain an ABCFV of 6.8, 8.1, 7.9, and 8.2 mL/bottle, respectively. Conclusions Partnering with a specific unit and providing monthly volume reports with educational sessions has a direct positive correlation on increasing ABCFVs. Increasing ABCFVs has the potential to decrease false-negative blood cultures, time to detection of positive blood cultures, and time to appropriate and specific antimicrobial therapy, as well as improve patient outcomes in high-acuity patient care units.

scholarly journals 394. Pseudo-outbreak of Coagulase-negative Staphylococcus Species from Blood Cultures Highlights Unique Challenges in Care of Critically Ill Patients With COVID-19

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S266-S266
Author(s):  
Stacy Park ◽  
April E Attai ◽  
Kyle Enfield ◽  
Taison Bell ◽  
Brandon Hill ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Culture ◽  
Peripheral Blood ◽  
Blood Cultures ◽  
Coagulase Negative Staphylococcus ◽  
Clinical Microbiology Laboratory ◽  
Blood Draw ◽  
Usual Practice ◽  
Standard Work

Abstract Background In response to the COVID-19 pandemic, a dedicated intensive care unit for patients infected with SARS-CoV-2 was created at our institution. We noticed a marked increase in the number of blood cultures positive for coagulase-negative Staphylococcus species (CoNS) that highlights unique challenges that arise with the creation of new units and workflows. Methods We reviewed all blood culture results from the COVID-19 intensive care unit (CoVICU) from April 15 to May 29. We reviewed all blood cultures taken from the oncology ward, medical intensive care unit (MICU), and emergency department (ED) for the same time frame as a comparison. We calculated contamination rates, using the clinical microbiology laboratory criteria for possible contaminants based on species and number of positive blood cultures. Results There were 324 total blood cultures collected from the CoVICU with 27/324 (8.3%) positive for organisms deemed contaminant, 10/324 (3.1%) were positive considered bloodstream infections (BSI); the ratio of BSI:contaminant was 1:2.7. For the MICU, ED, and oncology units contamination rates were 2/197 (1%), 33/747 (4.4%), and 2/334 (0.6%), respectively; and the ratio of BSI:contaminant was 5:1, 2.2:1, and 17.5:1, respectively. There was a significant relationship between contamination rates and unit, X2(3, N = 1602) = 30.85, p &lt; 0.001. Conclusion Upon investigation, peripheral blood draw kits were not stocked in the CoVICU. Additionally, certain components of standard work for blood culture collection (e.g. glove exchange) could not be performed per usual practice due to isolation precautions. Peripheral blood draws were routinely performed by nurses in CoVICU and MICU while phlebotomy performed these in other comparison units. We suspect that lack of availability of blood draw kits and disruption of typical workflow in isolation rooms contributed to an unusually high number of contaminated blood cultures among patients admitted to the CoVICU. Notably, the CoVICU and MICU providers were the same pool of caregivers, further supporting a process issue related to isolation precautions. Institutions should be aware of the need for extra attention to supply chain management and examination of disruption to standard work that arise in the management of COVID-19 patients. Disclosures All Authors: No reported disclosures

Nosocomial Bloodstream Infections in Children in Intensive Care Unit: Organisms, Sources, Their Sensitivity Pattern and Outcome of Treatment

2017 ◽  
Vol 35 (3) ◽  
pp. 115-122
Author(s):  
Syed Ahsan Tauhid ◽  
MAK Azad Chowdhury ◽  
Md Mahbubul Hoque ◽  
MA Kamal ◽  
Emdadul Haque
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Culture ◽  
Nosocomial Infections ◽  
Negative Impact ◽  
Bloodstream Infections ◽  
Suction Catheter ◽  
Third Generation ◽  
Gram Negative ◽  
Sensitivity Pattern

Background: Nosocomial bloodstream infection in paediatric ICU is a leading, preventable infectious complication in critically ill patients and has a negative impact on patient’s outcome. This study was done to determine the type of pathogens responsible for nosocomial infections and its sensitivity pattern, to evaluate the probable sources (fomites) of nosocomial infections and also to compare the outcome of treatment between children with and without nosocomial bloodstream infections in terms of length of ICU stay and mortalityMaterial and methods: This study was conducted in the intensive care unit of Dhaka Shishu(children) hospital. Children between 0-5 years of age were included in the study. Blood culture positive case at the time of admission and Children discharged or died within 48 hours of admission were excluded. When children clinically suspected to have nosocomial infections, their blood culture and swab culture of probable sources were done.Results: Out 110 patients, 23(20.9%) patients developed nosocomial BSI. Neonates were found to be more susceptible to develop nosocomial BSI. Most of the organisms (86%) were Gram negative bacilli. Klebsiella was the most common pathogens (30.78%) followed by acinatobacter (21.73%), E-coli (13.04%), Pseudomonas (8.7%). Type of micro-organisms and their sensitivity pattern obtained from blood culture and sources culture of corresponding patient were almost similar which indicate the clue for probable source of nosocomial infection. Microorganisms were almost sensitive to Imipenem but there were high resistance to commonly used antibiotics including third generation cephalosporins. ICU acquired infections increase hospital mortality and duration of hospital stay.Conclusion: Nosocomial bloodstream infections in children in ICU are associated with high mortality rate and prolong hospital stay. Neonates are more susceptible to develop nosocomial BSI than children aged above 28 days. Gram negative organisms are predominant isolates and are developing resistance to commonly used antibiotics including third generation cephalosporin. Imipenem is the most effective and reliable antibiotic option. Fomites especially health care device including IV canula, suction catheter, endotracheal tubes, oxygen mask are the important probable sources of nosocomial infections.J Bangladesh Coll Phys Surg 2017; 35(3): 115-122

Sign in / Sign up

Export Citation Format

Share Document