Evaluation of time to antibiotic therapy after implementation of an updated rapid diagnostic test for gram-negative bacteremia
- 1Department of Clinical Pharmacy Services, Westchester Medical Center, Valhalla, New York, USA
- 2Department of Infectious Diseases Services, Westchester Medical Center, Valhalla, New York, USA
- 3Department of Pathology, Westchester Medical Center, Valhalla, New York, USA
Abstract
Rapid pathogen identification optimizes antibiotic therapy in bacteremia and can be achieved through molecular-based diagnostic tests. This study assesses the clinical impact after the implementation of an updated multiplex PCR panel (BIOFIRE Blood Culture Identification 2, BCID2). This single-center, retrospective, quasi-experimental study compared outcomes in adult patients with gram-negative bloodstream infections (GN-BSIs) pre and post BCID2 implementation. Data were collected from 1 March 2022 to 1 March 2024. Patients were included if they were ≥18 years of age, had a gram-negative organism identified by the panels, and received ≥48 h of antibiotics. The primary outcome was time to effective antimicrobial therapy; secondary outcomes included time to appropriate therapy, 30-day mortality, and hospital length of stay. A total of 180 patients were included (90 per BCID and BCID2 groups). Baseline characteristics were similar: median age 62 years, mostly non-critically ill, Charlson Comorbidity Index 4, and Pitt Bacteremia score 1 in both groups. Median time to effective therapy was reduced in the BCID2 vs BCID group (1 vs 4 h, P = 0.004) as well as time to appropriate therapy (25 vs 49 h, P = 0.627). In the ESBL subgroup, BCID2 significantly reduced time to effective therapy (0.5 vs 3 h, P = 0.006) and time to appropriate therapy (16 vs 44 h, P = 0.016). There was no significant difference in mortality (6.7% vs 8.9%, P = 0.756) or length of stay (10 vs 14 days, P = 0.134) between BCID and BCID2 groups. The implementation of BCID2 significantly reduced time to effective therapy in GN-BSIs, particularly among resistant organisms.
IMPORTANCE: This study evaluated the impact of transitioning from BCID to BCID2 panel in gram-negative bloodstream infections to address gaps in resistance detection and assess whether expanded molecular diagnostics improve time to antibiotic therapy and clinical outcomes.
Related
- Direct Oral Challenge for Penicillin Allergy: A Hospital Implementation Evaluation Via the International Network of Antibiotic Allergy Nations (iNAAN) Study
- Diagnostic Tissue Re-Evaluation Supporting the Observation of a ¹¹C-Methionine PET-Negative Residual Paraskeletal Mass in Multiple Myeloma
- Diagnostic performance, implementation fidelity, and costs of the World Health Organization three-test HIV testing strategy in Malawi: a national retrospective evaluation
- Ethiopia’s first health-sector public–private partnership: a qualitative evaluation of the design, procurement, and early implementation of an integrated diagnostic center
- External Validation of the PACTO Risk Score for Infective Endocarditis in Patients With Coagulase-Negative Staphylococcal Bacteremia: A Multicenter Cohort Study.
BibTeX
@article{hussein2026evaluation,
title = {{Evaluation of time to antibiotic therapy after implementation of an updated rapid diagnostic test for gram-negative bacteremia}},
author = {Rawan Hussein and Leslie Lee and Rajat Nog and Donald Chen and Vishnu Chaturvedi and Nicholas Feola},
journal = {Journal of Clinical Microbiology},
year = {2026},
month = aug,
doi = {10.1128/jcm.00328-26},
url = {https://doi.org/10.1128/jcm.00328-26},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Evaluation of time to antibiotic therapy after implementation of an updated rapid diagnostic test for gram-negative bacteremia
AU - Rawan Hussein
AU - Leslie Lee
AU - Rajat Nog
AU - Donald Chen
AU - Vishnu Chaturvedi
AU - Nicholas Feola
PY - 2026
DA - 2026/08/31
JO - Journal of Clinical Microbiology
DO - 10.1128/jcm.00328-26
UR - https://doi.org/10.1128/jcm.00328-26
AB - Rapid pathogen identification optimizes antibiotic therapy in bacteremia and can be achieved through molecular-based diagnostic tests. This study assesses the clinical impact after the implementation of an updated multiplex PCR panel (BIOFIRE Blood Culture Identification 2, BCID2). This single-center, retrospective, quasi-experimental study compared outcomes in adult patients with gram-negative bloodstream infections (GN-BSIs) pre and post BCID2 implementation. Data were collected from 1 March 2022 to 1 March 2024. Patients were included if they were ≥18 years of age, had a gram-negative organism identified by the panels, and received ≥48 h of antibiotics. The primary outcome was time to effective antimicrobial therapy; secondary outcomes included time to appropriate therapy, 30-day mortality, and hospital length of stay. A total of 180 patients were included (90 per BCID and BCID2 groups). Baseline characteristics were similar: median age 62 years, mostly non-critically ill, Charlson Comorbidity Index 4, and Pitt Bacteremia score 1 in both groups. Median time to effective therapy was reduced in the BCID2 vs BCID group (1 vs 4 h, P = 0.004) as well as time to appropriate therapy (25 vs 49 h, P = 0.627). In the ESBL subgroup, BCID2 significantly reduced time to effective therapy (0.5 vs 3 h, P = 0.006) and time to appropriate therapy (16 vs 44 h, P = 0.016). There was no significant difference in mortality (6.7% vs 8.9%, P = 0.756) or length of stay (10 vs 14 days, P = 0.134) between BCID and BCID2 groups. The implementation of BCID2 significantly reduced time to effective therapy in GN-BSIs, particularly among resistant organisms. IMPORTANCE: This study evaluated the impact of transitioning from BCID to BCID2 panel in gram-negative bloodstream infections to address gaps in resistance detection and assess whether expanded molecular diagnostics improve time to antibiotic therapy and clinical outcomes.
SN - 0095-1137
SN - 1098-660X
ER -