RESUMO
The FilmArray blood culture identification (BCID) panel is a rapid molecular diagnostic test approved for use with positive blood culture material. We describe a fatal case of meningococcemia with central nervous system (CNS) involvement detected using the BCID test with culture-negative blood and cerebrospinal fluid.
Assuntos
Bacteriemia/diagnóstico , Técnicas Bacteriológicas , Sangue/microbiologia , Líquido Cefalorraquidiano/microbiologia , Meningite Meningocócica/diagnóstico , Técnicas de Diagnóstico Molecular , Neisseria meningitidis/isolamento & purificação , Bacteriemia/complicações , Bacteriemia/microbiologia , Evolução Fatal , Feminino , Humanos , Lactente , Meningite Meningocócica/complicações , Meningite Meningocócica/microbiologiaRESUMO
The purpose of this study was to evaluate the impact of the FilmArray Blood Culture Identification (BCID) Panel on the management of patients with blood cultures growing gram positive cocci and Candida. We retrospectively compared clinical and economic outcomes between patients during the BCID testing period and a matched historical control group before BCID testing was introduced. A total of 84 BCID patients were matched to 252 historical controls. BCID identification of coagulase negative staphylococci contaminants resulted in shorter post-culture length of stay (P < 0.008) and saved roughly $30,000 per 100 patients tested. The BCID led to shorter duration of empirical vancomycin for patients with contaminated blood cultures (P = 0.005) and methicillin-susceptible Staphylococcus aureus bacteremia (P < 0.001). Patients with vancomycin-resistant enterococcal bacteremia received active therapy earlier than historical controls (P = 0.047). The BCID, coupled with antimicrobial stewardship intervention, was a cost effective tool to improve patient care.