UnityPoint Health – Des Moines is introducing the new FDA cleared test, FilmArray Blood Culture Identification (BCID) Panel developed by BioFire Diagnostics, Inc. This test allows rapid identification of common pathogens found in blood cultures. Previous studies have shown that rapid pathogen identification can result in early transition to the most appropriate therapy, shorter hospital stay, and improved clinical outcomes.
This panel tests 27 targets: 8 Gram-positive bacteria, 11 Gram-negative bacteria, 5 Candida species and 3 antibiotics resistance genes (mecA, van A/B and KPC).
The results will typically be available within two hours of a positive signal from a blood culture bottle. The detection rate of blood pathogens in reports varies from 81% to 96%, including pathogens not included in the panel targets, when compared to final blood cultures. The sensitivity and specificity for targeted organisms and resistance genes are mostly greater than 95%. Final susceptibilities will be available in 24-72 hours and should always be reviewed to determine whether therapy adjustments need to be made.
Bacteremia can be caused by organisms not included in this panel and certain infections are polymicrobial in nature. Therefore therapy should be monitored and adjusted with other clinical conditions, including the source of potential primary infection, until definitive cultures and susceptibilities of all sites of infection have returned.
Method: This test uses a multiplex PCR-based nucleic acid amplification of DNA targets directly from positive blood culture samples identified by a continuous monitoring automated blood culture system that demonstrates the presence of organisms as determined by Gram stain.
Use: Rapid blood pathogen identification in positive blood cultures
This test will be utilized on the first set of blood cultures to turn positive on a patient in a 24 hour period, if the Gram stain performed on the positive culture suggests one of these pathogens. Testing will be performed on only one bottle from a set unless the Gram stain on the second bottle shows a different morphology. It will also only be performed on the first bottle to become positive in a 24 hour period- provided additional bottles exhibit the same Gram stain morphology. There may be exceptions to this policy if the initial bottle suggests the presence of a possible contaminant and subsequent bottles are also positive (for example: The first bottle to turn positive in a set shows Gram-positive cocci in clusters in the Gram stain, and the results of the FilmArray test indicate positive for Staphylococcus, but negative for S. aureus . This indicates a coagulase negative Staphylococcus species- a common skin contaminant found in blood cultures. If subsequent blood culture sets turn positive and show Gram positive cocci in clusters, they will have the FilmArray testing performed on them to rule out S. aureus- a common cause of sepsis.) This test may also be performed by physician request on positive blood bottles with the requisite Gram stain morphology.
Reference Range: Not detected.
Testing Schedule: Twenty-four (24) hours a day, seven (7) days a week. Results of the Gram stain examination will be phoned to the ordering provider along with indication that the Blood Culture Identification (BCID) Panel will be performed and available in the patient’s chart electronically in two (2) hours.
Ordering: This test is ordered by the Microbiology Department as indicated.
CPT: 87150x24
For additional information:
Technical Contact: Kathie Rogers, MT(ASCP), Ph.D; Microbiology
Manager
Email: Kathie.Rogers@unitypoint.org
Phone: (515) 241-5248