Use of a molecular syndromic panel for the etiological diagnosis of bloodstream infections in critically ill patients: impact on clinical outcomes and antimicrobial use from a multicenter, prospective study

Background Bloodstream infections (BSI) frequently occur in critically ill patients and remain associated with high mortality rates.Methods A prospective, observational, multicenter investigation was carried out through the MULTI-SITA platform to evaluate how the addition of a molecular syndromic panel, the BIOFIRE® Blood Culture Identification 2 (BCID2) Panel (BCID2 panel), to conventional blood culture diagnostics influenced key clinical endpoints and antimicrobial use. The primary endpoint was all-cause mortality within 30 days following the onset of BSI.Results Among the 126 included critically ill patients with BSI, multivariable analysis identified SOFA score (hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.09–1.34, p < 0.001), other concomitant infections requiring antibiotic therapy (HR 2.61, 95% CI 1.18–5.79, p = 0.018), and BSI caused by Acinetobacter spp. (HR 4.35, 95% CI 1.10–17.18, p = 0.036), Staphylococcus aureus (HR 3.38, 95% CI 1.26–9.08, p = 0.016), or Stenotrophomonas maltophilia (HR 15.97, 95% CI 2.43–104.54, p = 0.004) as associated with increased mortality, while no association was observed between use of the BCID2 panel and mortality (HR 0.97, 95% CI 0.42–2.25, p = 0.941). In secondary analyses, the use of the BCID2 panel resulted in more events of either early antimicrobial de-escalation or initiation of appropriate therapy at day one from BSI onset compared with a standard blood culture workflow (55.6% vs. 31.7%, p = 0.015).Conclusion In critically ill patients with BSI, implementation of a molecular syndromic panel influenced antimicrobial management decisions without affecting mortality. Additional investigations are warranted to clarify the long-term antimicrobial stewardship implications of treatment strategies guided by molecular syndromic panels-based diagnostic workflows.

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Journal
Annals of Medicine
Published
2026-11-01
DOI
https://doi.org/10.1080/07853890.2026.2750724
Primary Topic
Bacterial Identification and Susceptibility Testing
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article
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article

Use of a molecular syndromic panel for the etiological diagnosis of bloodstream infections in critically ill patients: impact on clinical outcomes and antimicrobial use from a multicenter, prospective study

Giulia Spurio, Federica Portunato, Chiara Fanelli, Antonio Di Biagio et al.
Annals of Medicine
Bacterial Identification and Susceptibility Testing
article

Use of a molecular syndromic panel for the etiological diagnosis of bloodstream infections in critically ill patients: impact on clinical outcomes and antimicrobial use from a multicenter, prospective study

Giulia Spurio, Federica Portunato, Chiara Fanelli, Antonio Di Biagio, Vincenzo Scaglione, Maria Mazzitelli, Matteo Rinaldi, Nicola Rosso, Laura Magnasco, Chiara Oltolini, Anna Gidari, Gian María Rossolini, Alessandro Limongelli, Marco Ripa, Andrea Parisini, Małgorzata Mikulska, Nicholas Geremia, Chiara Maci, Andrea Lombardi, Anna Maria Cattelan, Daniele Riccucci, Marco Piscaglia, Greta Cattardico, F Cosentino, Carlo Pallotto, Marco Muccio, Paola Del Giacomo, Alice Cappello, Elisabetta Blasi Vacca, Matteo Bassetti, Sara Grignolo, Mara Tomasello, Edoardo Campanella, Carlo Alberto Peri, Nicoletta Bobbio, Lisa Malincarne, Francesco Saverio Serino, Gennaro De Pascale, Ivana Rita Maida, Giuseppe Vittorio De Socio, Vincenzo Di Pilato, Mauro L. Giacomini, Brunella Posteraro, Sara Mora, Sandro Panese, Emanuele Pontali, Maria Carolina Benvenuto, Anna Lisa Garlaschelli, Vincenzo Spagnuolo, Stefania Tigano, Federico D’Amico, Anna Elisa Marchese, Giovanna Travi, Maddalena Giannella, Lorenzo Ball, Teresa Fasciana, Angela Raffaella Losito, Sabrina Guastavino, Andrea Cortegiani, Gabriele Di Meco, Alessandra Bandera, Giacomo Grasselli, Paola Morici, Daniele Roberto Giacobbe, Cristina Campi, Antonio Muscatello, Marta Colaneri, Nicolo’ Antonino Patroniti, Carlo Torti, Marco Merli, Filippo Del Puente, Maria Vittoria Cossu, Andrea Marıno, Maria Chiara Meloni, A. Caroli, Davide Mangioni, Laura Curci, Chiara Gullotta, Chiara Robba, Maurizio Sanguinetti, Federica Briano, Denise Battaglini, Claudia Bartalucci, Bruno Santi Cacopardo, Giulia Viglietti, Elena Momesso, Marta Vecchi, Matteo Passerini, Ylenia Murgia, Fabiola Cammarota, Alessio Signori, Luca De Paola, Giacomo Gonnelli, Maurizio Fedriga, Annaflavia Lamarina, Stefano Antola, A. Vena, Elena Simoncini, Selene Gallone, Michele Piana
article en

Abstract

Background Bloodstream infections (BSI) frequently occur in critically ill patients and remain associated with high mortality rates.Methods A prospective, observational, multicenter investigation was carried out through the MULTI-SITA platform to evaluate how the addition of a molecular syndromic panel, the BIOFIRE® Blood Culture Identification 2 (BCID2) Panel (BCID2 panel), to conventional blood culture diagnostics influenced key clinical endpoints and antimicrobial use. The primary endpoint was all-cause mortality within 30 days following the onset of BSI.Results Among the 126 included critically ill patients with BSI, multivariable analysis identified SOFA score (hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.09–1.34, p < 0.001), other concomitant infections requiring antibiotic therapy (HR 2.61, 95% CI 1.18–5.79, p = 0.018), and BSI caused by Acinetobacter spp. (HR 4.35, 95% CI 1.10–17.18, p = 0.036), Staphylococcus aureus (HR 3.38, 95% CI 1.26–9.08, p = 0.016), or Stenotrophomonas maltophilia (HR 15.97, 95% CI 2.43–104.54, p = 0.004) as associated with increased mortality, while no association was observed between use of the BCID2 panel and mortality (HR 0.97, 95% CI 0.42–2.25, p = 0.941). In secondary analyses, the use of the BCID2 panel resulted in more events of either early antimicrobial de-escalation or initiation of appropriate therapy at day one from BSI onset compared with a standard blood culture workflow (55.6% vs. 31.7%, p = 0.015).Conclusion In critically ill patients with BSI, implementation of a molecular syndromic panel influenced antimicrobial management decisions without affecting mortality. Additional investigations are warranted to clarify the long-term antimicrobial stewardship implications of treatment strategies guided by molecular syndromic panels-based diagnostic workflows.

Annals of MedicineVol. 58(1)
Università Cattolica del Sacro Cuore (IT), Vita-Salute San Raffaele University (IT), University of Sassari (IT), University of Milan (IT), University of Cambridge (GB), University of Perugia (IT), Agostino Gemelli University Polyclinic (IT), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Ente Ospedaliero Ospedali Galliera (IT), University of Catania (IT), Luigi Sacco Hospital (IT), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT), Ospedale di San Donà di Piave (IT), Azienda Ospedaliero-Universitaria Careggi (IT), Azienda USL di Bologna (IT), IRCCS Ospedale San Raffaele (IT), Ospedale dell' Angelo (IT), Ospedale Policlinico San Martino (IT), Azienda Ospedale - Università Padova (IT), Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone" di Palermo (IT), Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele (IT), University of Florence (IT), University of Genoa (IT), University of Palermo (IT), University of Bologna (IT)
Openalex Percentile: Top 14%
Bacterial Identification and Susceptibility Testing
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