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The impact of the BIOFIRE® Blood Culture Identification 2 Panel on antimicrobial treatment of children with suspected systemic inflammatory response syndrome and sepsis

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Abstract

This study aimed to assess the therapeutic effects of implementing the BioFire® Blood Culture Identification 2 (BCID2) Panel (bioMérieux, Marcy l’Etoile, France) in the clinical practice of children with sepsis. This retrospective cross-sectional study included children from 15 days of age to 18 years old with sepsis and of whom the BCID2 Panel was studied from the positive blood culture. If the antimicrobial treatment was changed according to the results of BCID2 Panel, it was recorded and re-grouped as targeted antimicrobial therapy, de-escalation of the antimicrobial treatment and shifting to another antimicrobial drug if any antimicrobial resistance was detected. Seven-days and thirty-days mortality rate was recorded. Thirty-two patients with 36 septic episodes with positive BCID2 Panel results were included. The median age was 10 months 15 days (ranging from 15 days to 16.5 years). The mean difference between having positive results by the BCID2 Panel and conventional culture methods was 82.2 ± 45.4 h (ranging from 12.3 to 207 h). Effect of the BCID2 Panel on the antimicrobial treatment was detected in 69.4% of the episodes (n = 25). Glycopeptides were ceased at 6 patients, piperacillin/tazobactam was ceased at 6 patients, and cefotaxime was ceased at one patient and de-escalation was achieved in 13 episodes which formed the 36.1% of the initial antimicrobial treatment.

   Conclusion: The BCID2 Panel had an important impact on the patients care and optimization according to the principles of antimicrobial stewardship. The BCID2 Panel may be one of the key items for rapid and accurate diagnosis in children with sepsis. Blood culture is still the mainstay for especially detection of antimicrobial drug resistance, while BCID2 tests had several advantages such as speed and diagnostic accuracy as good as blood culture.

What is Known:

• The BioFire® Blood Culture Identification 2 (BCID2) Panel (bioMérieux, Marcy l’Etoile, France) is a well-validated assay that allows for the simultaneous identification of 43 nucleic acid targets associated with bloodstream infections within about 1 h.

What is New:

• BCID2 Panel had a direct impact on the patient’s treatment decision at the 69.4% of the sepsis episodes.

• The clinicians received the microbiological results 82.2 h earlier with BCID2 panel compared to blood culture methods with antimicrobial resistance and de-escalation of the antimicrobial drugs was achieved at 13 episodes which formed the 36.1% of the initial treatment.

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Data can be accessed upon request to the corresponding author.

Abbreviations

BCID2 :

The BioFire® Blood Culture Identification 2

SIRS :

Systemic inflammatory response syndrome

PCR :

Polymerase Chain Reaction

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Authors and Affiliations

  1. Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Children’s Hospital, Konak, Izmir, 35210, Turkey

    Ilker Devrim, Pelin Kacar, Gizem Guner Ozenen, Deniz Ergun, Hincal Ozbakır, Mustafa Gulderen, Miray Yilmaz Celebi, Arife Ozer, Aybüke Akaslan Kara & Nuri Bayram

  2. Department of Medical Microbiology, University of Health Sciences Dr. Behçet Uz Children’s Hospital, Izmir, Turkey

    Fahri Yuce Ayhan & Arzu Bayram

Authors
  1. Ilker Devrim
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  2. Fahri Yuce Ayhan
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  3. Pelin Kacar
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  4. Gizem Guner Ozenen
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  5. Arzu Bayram
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  6. Deniz Ergun
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  9. Miray Yilmaz Celebi
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  10. Arife Ozer
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  11. Aybüke Akaslan Kara
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  12. Nuri Bayram
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Fahri Yuce Ayhan, Pelin Kacar, Gizem Guner Ozenen, Arzu Bayram, Deniz Ergun, Hincal Ozbakir, Miray Yilmaz Celebi, Mustafa Gulderen, Aybuke Akaslan Kara, Arife Ozer, Nuri Bayram. Analysis were performed by Ilker Devrim. The first draft of the manuscript was written by Ilker Devrim and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Gizem Guner Ozenen.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Local Ethical Committee of Dr. Behcet Uz Children's Training and Research Hospital.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Competing interests

The authors declare no competing interests.

Additional information

Communicated by Tobias Tenenbaum

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Devrim, I., Ayhan, F.Y., Kacar, P. et al. The impact of the BIOFIRE® Blood Culture Identification 2 Panel on antimicrobial treatment of children with suspected systemic inflammatory response syndrome and sepsis. Eur J Pediatr 183, 1353–1360 (2024). https://doi.org/10.1007/s00431-023-05381-7

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  • DOI: https://doi.org/10.1007/s00431-023-05381-7

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