Daily Archives: June 10, 2022

Blood biofire?

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I read a little more about the blood culture biofire that we’ve started seeing – BCID2 – 43 PCR results including organisms and resistance – https://www.biofiredx.com/products/the-filmarray-panels/filmarraybcid/ and some evidence – Banerjee et al randomized 617 patients with positive blood cultures to usual care (takes about two days to get results from micro lab cultures) vs BCID +- stewardship team – showed shorter time to organism identification and appropriate abx changes – no difference in mortality, LOS, or cost 

Comparison of time to organism identification, availability of phenotypic antimicrobial susceptibility results, and first appropriate modification of antimicrobial therapy for the subset of study subjects with organisms represented on the rapid multiplex polymerase chain reaction (rmPCR) panel (n = 481). Time 0 is when the positive Gram stain result was reported. Median time in hours (interquartile range [IQR]) to organism identification: control 22.3 (17–28), both rmPCR and rmPCR + stewardship 1.3 (0.9–1.6); de-escalation: control 39 (19–56), rmPCR 36 (22–61), rmPCR + stewardship 20 (6–36); escalation: control 18 (2–63), rmPCR 4 (1.5–24), rmPCR + stewardship 4 (1.8–9). *P < .05 vs control; †P < .05 vs control and rmPCR groups.https://academic.oup.com/cid/article/61/7/1071/289120 They also have a small number of discrepancies (11 cases) in their Table 2 – but pretty reasonable and only 3 true cases of organism identification discrepancy

I’m excited to see this and look forward to using it clinically!