Evaluation of Diagnostic Panel for Rapid Blood Culture Identification of Pathogenes in Bloodstream Infection at The University Children Hospital- Skopje

Background: Bloodstream infection is a leading cause of morbidity and mortality in critically ill children in the University Children Hospital-Skopje.

Objective: The aim of study is an early diagnosis and rapid therapeutic intervention of sepsis during the critical first hour of develop the clinical signs in paediatric patients , is crucial to stop progression into severe sepsis and septic shock.

Methods: We investigated 350 patiens with clinical signs suspected for sepsis in the Univetsity Children Hospital-Skopje. The new multiplex polymerase chain reaction–based rapid diagnostic test (BioFire FilmAray Blood Culture Identification (BCID) was used for early recognition of 27 targets of sepsis, 24 pathogenes and 3 antibiotic resistance genes (mecA, blaKPC, and Van A/VanB), associated with bloodstream infection sample 200ul from positive blood culture detected on BACT/ALERT 3D 60. The result report indicating the detected microorganism is obtained after 60 minutes.

Results: We detected 51 positive blood culture, 30 were single blood culture isolate. Twenty eight of the isolates were Gram positive bacteria Staphylococcus aureus, which twenty five were methicillin resistant, two were Streptococcus pneumonia. None of the Gram positive isolates were vancomycin resistant. Twelve of the isolates were Gram negative bacteria, seven were Seratia marcescens, five were Enterobacteriae. Nine had two or three bacteria at the same time. Rapid diagnosis of the causing microorganism and relevant resistance determinants is important for early administration and modification of appropriate antimicrobial therapy, as well as reduced antimicrobial resistance selection.

Conclusion: FilmAray Blood Cell Identification quickly identifies the pathogen in the blood culture of pediatric patients with suspected sepsis, a short time to the results can be of added value to optimize the clinical management of patients, improves the outcome of the potential complications for severe sepsis and septic shock and reduces hospital treatment costs.