In addition, several molecular systems provide rapid identification of infectious pathogens from positive blood culture bottles, either in targeted (single-plex) assays or in broadly multiplexed panels ( 5, – 7). These include matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF) ( 4), now commonly seen supplanting biochemical/phenotypic identification systems. The use of continuously read, automated blood culture systems over the last 3 decades has mitigated the time to detection issue and, in recent years, several systems have become widely available that can markedly reduce the time required for microbial identification once blood cultures have become positive. While these methods have a long history of use, they suffer from limits of sensitivity and prolonged time to results. Typically, this has been accomplished by using liquid media blood culture systems, coupled with phenotypic identification and antimicrobial susceptibility testing (AST) ( 3). Detection and identification of the causes of infection are fundamental to directing effective therapy and limiting the sequelae of these events. The performance of the ePlex BCID Gram-negative and Gram-positive panels was evaluated in a predominantly pediatric oncology population, providing a unique look at its performance in a high-risk group, where rapid diagnostic information for bloodstream infections could be of particular value for clinical care providers.īloodstream infections are a major cause of morbidity and mortality, with significant costs to society and health care systems ( 1, 2). The GenMark Dx ePlex blood culture identification (BCID) panels, recently cleared by the FDA, have an expanded number of targets for both identification and resistance, much larger than other, automated, broad-panel PCR assays. Multiplex PCR systems that provide bacterial identification directly from the blood culture bottle allow for earlier characterization of pathogens. Rapid identification of the causative agent of bloodstream infections is critical for patient treatment and improved outcomes. IMPORTANCE Bloodstream infections are a major cause of morbidity and mortality and result in significant costs to health care systems. The results showed good overall performance of these panels for rapid, accurate detection of bloodstream pathogens in this high-risk population. Accuracy for on-panel organisms was 89% (CI, 76% to 95%) for the Gram-positive panel, with four misidentifications and one not detected, and 93% (CI, 82% to 98%) for the Gram-negative panel, with two misidentifications and one not detected. A total of 112 blood cultures were tested by the ePlex BCID GN and GP panels and results were compared to those from standard-of-care testing. The performance of the ePlex BCID Gram-negative (GN) and Gram-positive (GP) panels were evaluated in a predominantly pediatric oncology population. The GenMark Dx ePlex blood culture identification (BCID) panels have an expanded number of targets for both identification and genotypic markers of antimicrobial resistance. Multiplex PCR systems that provide bacterial identification directly from the blood culture bottle allow for earlier detection of pathogens. Bloodstream infections are a major cause of morbidity and mortality and result in significant costs to health care systems.
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