Efficacy of the FilmArray blood culture identification panel for direct molecular diagnosis of infectious diseases from samples other than blood

Abstract

Molecular-based techniques reduce the delay in diagnosing infectious diseases and therefore contribute to better patient outcomes. We assessed the FilmArray blood culture identification (BCID) panel (Biofire Diagnostics/bioMé rieux) directly on clinical specimens other than blood: cerebrospinal, joint, pleural and ascitic fluids, bronchoscopy samples and abscesses. We compared the results from 88 samples obtained by culture-based techniques. The percentage of agreement between the two methods was 75 % with a Cohen k value of 0.51. Global sensitivity and specificity using the FilmArray BCID panel were 71 and 97 %, respectively. Sensitivity was poorer in samples with a low bacterial load, such as ascitic and pleural fluids (25 %), whereas the sensitivity for abscess samples was high (89 %). These findings suggest that the FilmArray BCID panel could be useful to perform microbiological diagnosis directly from samples other than positive blood cultures, as it offers acceptable sensitivity and moderate agreement with conventional microbiological methods. Nevertheless, cost-benefit studies should be performed before introducing this method into algorithms for microbiological diagnostics.

Performance of the FilmArray Blood culture identification panel in positive blood culture bottles and cerebrospinal fluid for the diagnosis of sepsis and meningitis

“…The detection limits shown for the mentioned microorganisms around 10E+05 CFU/ml should be sufficient using this method for CSF from positive BC bottles, but is critical when used for direct CSF testing [ 21 ]. A recent publication describes the first use of the FilmArray BCID panel for direct testing of 19 CSF specimens presenting a sensitivity of 73% and a specificity of 100% [ 22 ]. In our small pilot study (20 specimens) we detected a sensitivity of 50% and specificity of 92%, respectively, which is lower than in the study by Mico et al The low concordance between the FilmArray BCID panel and routine procedure might be from the result of the high detection limit and the fact, that only residual specimens were available for this retrospective analysis and prior treatment for routine procedures might have decreased bacterial load in these CSF specimens.…”

Syndromic Panel-Based Testing in Clinical Microbiology

“…Compared to culture, the sensitivity and specificity of the BCID panel were 71 and 97%, respectively. Samples with low bacterial loads, such as pleural fluid, yielded a lower sensitivity (25%) by BCID than did specimens with higher bacterial loads, such as abscess fluid, which showed a sensitivity of 89% (89). It is worth bearing in mind that the analytical sensitivity (i.e., limit of detection) of BCID was optimized for positive blood culture bottles and may not be ideal for direct testing of patient specimens.…”

Clinical and laboratory considerations for the rapid detection of carbapenem-resistant Enterobacteriaceae

“…As might be expected, the sensitivity for the detection of bacteria in these specimens was lower than what is observed for blood cultures (i.e., 71-89% sensitivity of the BCID as compared to conventional cultures). 21 This study did not include any CRE, so it is unclear what the performance for the detection of resistance genes might be. The main limitation of the BCID is the inclusion of only bla KPC as a target.…”