Evaluation of Microbiological Performance and the Potential Clinical Impact of the ePlex® Blood Culture Identification Panels for the Rapid Diagnosis of Bacteremia and Fungemia - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Frontiers in Cellular and Infection Microbiology Année : 2020

Evaluation of Microbiological Performance and the Potential Clinical Impact of the ePlex® Blood Culture Identification Panels for the Rapid Diagnosis of Bacteremia and Fungemia

Sabrina Bryant
  • Fonction : Auteur
Iyad Almahmoud
  • Fonction : Auteur
Isabelle Pierre
  • Fonction : Auteur
Julie Bardet
  • Fonction : Auteur
Saber Touati
  • Fonction : Auteur
Daniele Maubon
  • Fonction : Auteur
Claire Richarme
  • Fonction : Auteur
Max Maurin
  • Fonction : Auteur
Patricia Pavese
  • Fonction : Auteur
Yvan Caspar
  • Fonction : Auteur

Résumé

Molecular rapid diagnostic assays associated with antimicrobial stewardship have proven effective for the early adaptation of empiric therapy in bloodstream infections. The ePlex ® BCID (GenMark Diagnostics) Panels allow identification of 56 bacteria and fungi and 10 resistance genes in 90 min directly from positive blood cultures. We prospectively evaluated 187 sepsis episodes at Grenoble University Hospital and retrospectively analyzed the cases to measure the potential clinical impact of the ePlex BCID results. Identification of all pathogens was obtained for 164/187 (88%) bloodstream infections with 100% detection of antimicrobial resistance genes (17 bla CTX-M , 1 vanA , and 17 mecA genes). Only 15/209 (7%) strains were not covered by the panels. Sensitivity for detection of micro-organisms targeted by the RUO BCID-GP, BCID-GN, and BCID-FP Panels was respectively 84/84 (100%), 103/107 (96%), and 14/14 (100%). Interestingly, accurate identification of all pathogens was achieved in 15/17 (88%) polymicrobial samples. Retrospective analysis of medical records showed that a modification of antimicrobial treatment would have been done in 45% of the patients. Treatment modifications would have been an optimization of empiric therapy, a de-escalation or an escalation in respectively 16, 17, and 11% of the patients. Moreover, 11% of the samples were classified as contaminants or not clinically relevant and would have led to early de-escalation or withdrawal of any antibiotic. Detection of resistance genes in addition to identification alone increased escalation rate from 4 to 11% of the patients. Absence of the ePlex result was considered a lost opportunity for therapy modification in 28% of patients.

Domaines

Mycologie

Dates et versions

hal-03703144 , version 1 (23-06-2022)

Identifiants

Citer

Sabrina Bryant, Iyad Almahmoud, Isabelle Pierre, Julie Bardet, Saber Touati, et al.. Evaluation of Microbiological Performance and the Potential Clinical Impact of the ePlex® Blood Culture Identification Panels for the Rapid Diagnosis of Bacteremia and Fungemia. Frontiers in Cellular and Infection Microbiology, 2020, 10, ⟨10.3389/fcimb.2020.594951⟩. ⟨hal-03703144⟩
777 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More