Clinical Utility of Blood Culture Identification 2 Panel in Flagged Blood Culture Samples from the Intensive Care Unit of a Tertiary Care Hospital

Vashemane K Vineeth; Panchatcharam S Nambi; Ram Gopalakrishnan; Nandini Sethuraman; Yamunadevi Ramanathan; Chitra Chandran; Venkatasubramanian Ramasubramanian

doi:10.5005/jp-journals-10071-24709

Clinical Utility of Blood Culture Identification 2 Panel in Flagged Blood Culture Samples from the Intensive Care Unit of a Tertiary Care Hospital

Indian J Crit Care Med. 2024 May;28(5):461-466. doi: 10.5005/jp-journals-10071-24709.

Authors

Vashemane K Vineeth¹, Panchatcharam S Nambi², Ram Gopalakrishnan², Nandini Sethuraman³, Yamunadevi Ramanathan⁴, Chitra Chandran⁵, Venkatasubramanian Ramasubramanian²

Affiliations

¹ Department of General Medicine, Infectious Diseases Division, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, Karnataka, India.
² Department of Infectious Diseases, Apollo Hospitals, Chennai, Tamil Nadu, India.
³ Department of Microbiology, Apollo Hospitals, Chennai, Tamil Nadu, India.
⁴ Department of Infectious Diseases, Institute of Infection Control, Apollo Hospitals, Chennai, Tamil Nadu, India.
⁵ Department of Molecular Diagnostics, Apollo Hospitals, Chennai, Tamil Nadu, India.

Abstract

Background: The availability of rapid diagnostic platforms for positive blood cultures has accelerated the speed at which the clinical microbiology laboratory can identify the causative organism and facilitate early appropriate antimicrobial therapy. There is a paucity of data regarding the clinical utility of the blood culture identification 2 (BCID2) panel test and its correlation with phenotypic drug susceptibility testing (DST) in flagged blood culture bottles from intensive care units (ICUs) in countries such as India, which have high rates of multidrug-resistant gram-negative bacteria (MDR-GNB).

Materials and methods: We conducted a retrospective observational study in a tertiary care ICU on 200 patients above 18 years of age in whom a BCID2 test was ordered when blood cultures flagged positive.

Results: We found 99% concordance between BCID2 and cultures in the identification of bacteria and yeasts and 96.5% concordance between phenotypic and genotypic DST. Furthermore, BCID2 was available about 1.5 days earlier than conventional ID and DST and played a key role in tailoring antimicrobials in 82.5% of the patients. Polymyxin-based therapy was discontinued earlier after an empiric dose in 138 patients (69%) based on BCID2 reports.

Conclusion: In critically ill patients with monomicrobial bacteremia, BCID2 rapidly identifies bacteria and antimicrobial resistance (AMR) genes and is significantly faster than conventional culture and sensitivity testing. Antibiotics were escalated in more than a third of patients and de-escalated in almost a fifth on the same day. We recommend that all ICUs routinely incorporate the test in their antibiotic decision-making process and in antimicrobial stewardship.

How to cite this article: Vineeth VK, Nambi PS, Gopalakrishnan R, Sethuraman N, Ramanathan Y, Chandran C, et al. Clinical Utility of Blood Culture Identification 2 Panel in Flagged Blood Culture Samples from the Intensive Care Unit of a Tertiary Care Hospital. Indian J Crit Care Med 2024;28(5):461-466.

Keywords: Antimicrobial stewardship; Blood culture identification 2; Flagged cultures; Polymyxin.