Evaluation of the FilmArray Blood Culture Identification Panel on Detection of Pathogenic Microorganisms in Positive Blood Cultures: the First Clinical Report in Japan
Evaluation of the FilmArray Blood Culture Identification Panel on Detection of Pathogenic Microorganisms in Positive Blood Cultures: the First Clinical Report in Japan
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DOI：
10.7883/yoken.jjid.2017.414
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发表时间：
2018-03-01
影响因子：
2.2
通讯作者：
Kaku, Mitsuo
中科院分区：
文献类型：
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作者：
Saito, Kyoichi;Endo, Shiro;Kaku, Mitsuo
膜阵列(FA)是一种基于多重聚合酶链式反应的台式微生物检测系统。血培养鉴定(BCID)板是一种适用于FA的板，它通过在1h内检测阳性血培养中的14种细菌、4个细菌属、1个细菌科、5个酵母菌和3个耐药基因(mecA、肺炎克雷伯菌碳青霉烯酶[KPC]和Vana/B)来诊断脓毒症和/或系统性感染。FA-BCID板在53个样品中发现59个微生物；这一性能与MALDI-TOF MS分析相似；但1个样品中没有检测到1个细菌。此外，在12种葡萄球菌中检测到mecA基因，药敏试验均显示对甲氧西林耐药，而未检测到kpc和varA/B基因，与药敏试验结果一致。尽管日本需要更多关于抗菌素耐药性的信息，包括IMP-金属-β-内酰胺酶的活性，但FA-BCID小组可以快速检测出阳性血培养中的病原体，这种方法可能有助于脓毒症和/或全身感染的正确治疗，特别是在小医院。
FilmArray (FA) is a multiplex PCR-based desktop microbial detection system. The blood culture identification (BCID) panel is an adaptable panel for FA, which diagnoses sepsis and/or systemic infections by detecting 14 bacterial species, 4 bacterial genera, 1 bacterial family, 5 yeast species, and 3 antimicrobial resistance genes (mecA, Klebsiella pneumoniae carbapenemase [KPC], and vanA/B) in positive blood cultures within 1 h. We retrospectively evaluated the FA-BCID panel using 54 positive blood cultures, in which 57 bacterial and 3 yeast strains were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). The FA-BCID panel revealed 59 microorganisms in 53 samples; this performance was similar to that of MALDI-TOF MS analysis; however, 1 bacterium in 1 sample was not detected. In addition, mecA genes were detected in 12 Staphylococcus species, which all manifested methicillin resistance in susceptibility testing, whereas genes KPC and vanA/B were not detected, in agreement with the results of antimicrobial susceptibility testing. Although more information on antimicrobial resistance, including activity of IMP-metallo-beta-lactamases, is required in Japan, the FA-BCID panel can detect pathogenic microorganisms in positive blood cultures rapidly, and this method could be beneficial for proper treatment of sepsis and/or systemic infections, especially in small hospitals.