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

Bloodstream infections (BSI) frequently occur in critically ill patients and remain associated with high mortality rates. 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. 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). 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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Figshare
Published
2026-11-02
DOI
https://doi.org/10.6084/m9.figshare.34884228
Primary Topic
Bacterial Identification and Susceptibility Testing
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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, Vincenzo Scaglione et al.
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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, Vincenzo Scaglione, Maria Mazzitelli, Matteo Rinaldi, Laura Magnasco, Chiara Oltolini, Gian María Rossolini, Alessandro Limongelli, Marco Ripa, Małgorzata Mikulska, Nicholas Geremia, Alessio Signori, Chiara Maci, Anna Maria Cattelan, Daniele Riccucci, Marco Piscaglia, Greta Cattardico, Carlo Pallotto, Marco Muccio, Matteo Bassetti, Edoardo Campanella, Francesco Saverio Serino, Gennaro De Pascale, Giuseppe Vittorio De Socio, Vincenzo Di Pilato, Sandro Panese, Emanuele Pontali, Vincenzo Spagnuolo, Stefania Tigano, Anna Elisa Marchese, Giovanna Travi, Maddalena Giannella, Lorenzo Ball, Teresa Fasciana, Andrea Cortegiani, Alessandra Bandera, Giacomo Grasselli, Paola Morici, Daniele Roberto Giacobbe, Carlo Torti, Marco Merli, Filippo Del Puente, Maria Chiara Meloni, A. Caroli, Davide Mangioni, Laura Curci, Chiara Robba, Maurizio Sanguinetti, Federica Briano, Denise Battaglini, Claudia Bartalucci, Bruno Santi Cacopardo, Elena Momesso, Matteo Passerini, Maurizio Fedriga, A. Vena, Nicolò Patroniti, Ivana MAIDA, Mauro Giacomini, Andrea Marino
article en

Abstract

Bloodstream infections (BSI) frequently occur in critically ill patients and remain associated with high mortality rates. 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. 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). 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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