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Published on: February 10, 2011
Application of Biofire Filmarray Joint Infection Panel for Rapid Identification of Aetiology in a Necrotizing
Zoltán Tóth1, Bence Balázs1, Walter P Pfliegler2
1Medical Microbiology, Clinical Center, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.
Abstract:
Background: Monomicrobial Enterobacterales necrotizing fasciitis is associated with exceedingly high mortality rates. Although effective antimicrobial therapy is an important part of treatment, the traditional microbiological diagnostic methods are not fast enough to meaningfully influence early therapeutic decisions. Methods: Here, we report the application of the BioMérieux Biofire Filmarray Joint Infection Panel (BFJIP) for the rapid detection of the causative agent and susceptibility prediction in such a case. Aside from the BFJIP-based rapid diagnostic approach and culturing, the whole genome sequencing (WGS) of the causative agent was performed using Illumina MiSeq and Oxford Nanopore MinION platforms. Results: The BFJIP indicated the presence of K. pneumoniae, without KPC, VIM, IMP, NDM, OXA-48 carbapenemase genes, and CTX-M-type extended-spectrum beta-lactamases. Based on the WGS data, the isolate belonged to the K1-capsule-type ST23, harboured a pNTUH-2044-like plasmid, and was positive for all the virulence factors associated with this lineage. The conventional susceptibility results were also in accordance with the BFJIP results; the isolate lacked any of these acquired resistance mechanisms. Conclusions: Despite this being the first case of the successful identification of pathogenic bacteria in necrotising fasciitis using this assay, the BFJIP may become a useful tool for rapid identification of pathogens in necrotising fasciitis cases and guiding antimicrobial therapy for better clinical outcomes.
Insights
Rapid diagnostics like the Biofire Filmarray Joint Infection Panel (BFJIP) can quickly identify *Klebsiella pneumoniae* in necrotizing fasciitis, guiding faster treatment for better outcomes.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Genomics
Background:
- Monomicrobial *Enterobacterales* necrotizing fasciitis has high mortality rates.
- Traditional diagnostics delay crucial early treatment decisions.
Purpose of the Study:
- To evaluate the Biofire Filmarray Joint Infection Panel (BFJIP) for rapid pathogen detection in necrotizing fasciitis.
- To assess BFJIP's utility in guiding antimicrobial therapy.
Main Methods:
- Application of BFJIP for rapid diagnosis.
- Whole genome sequencing (WGS) using Illumina MiSeq and Oxford Nanopore MinION.
- Conventional microbiological culturing and susceptibility testing.
Main Results:
- BFJIP rapidly identified *Klebsiella pneumoniae* without common carbapenemase genes.
- WGS confirmed the isolate's lineage (ST23, K1-capsule) and virulence factors.
- Susceptibility testing aligned with BFJIP findings, showing no acquired resistance.
Conclusions:
- BFJIP successfully identified the causative agent in a necrotizing fasciitis case.
- This assay shows potential for rapid pathogen identification and antimicrobial therapy guidance.
- Early pathogen identification via BFJIP may improve clinical outcomes in necrotizing fasciitis.
