1368 - The Clinical Impact of BioFire BCID2 Compared to BCID in a U.S. Pediatric Hospital

Background: Multiplex PCR panels, particularly BioFire FilmArray Blood Culture Identification (BCID), have been shown to decrease time to pathogen identification and time to effective and optimal antimicrobial therapy. BioFire Blood Culture Identification 2 (BCID2) has an additional 17 targets and resistance genes compared to BCID. There is limited data on the impact of these expanded targets in pediatric populations.

Methods: We performed a head-to-head comparison between BioFire BCID2 with BCID when compared to standard culture. From January 2020- May 2020, we ran BCID2 simultaneously as a research use only prototype with the current standard of care on all blood culture specimens at Children’s Hospital Colorado. Percent agreement was calculated with BCID2 compared to standard culture and BCID compared to standard culture. Time to positivity, time to optimal therapy, and time to effective therapy were also calculated.

Results: We performed an interim analysis halfway through the study with 86 unique positive blood cultures. We found equal organism detection rates between BCID and BCID2 when compared to standard culture (88% each). BCID2 correctly identified 100% of target organisms.  There were 10 (12%) isolates that only grew in culture that were not BCID or BCID2 targets.   Compared to BCID, BCID2 was able to detect to the species level on 23 additional isolates.  Most notably, 3 Enterococcus faecalis isolates were detected on BCID2, which would have resulted in a theoretical decrease in time to optimal antimicrobial therapy. Three CTX-M genes were detected on the resistance panels for Enteric bacteria, which could have resulted in a theoretical decrease in time to effective therapy.

Conclusion: BioFire BCID2 had equal rates of detection when compared to BCID in pediatric patients. It has the additional advantage of detecting more organisms at the species level, with clinical significance for Enterococcus faecalis specifically. With the additional resistance genes, it also has the potential to impact care with early identification of ESBL-producing Enteric pathogens.