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Rapid Identification of Pathogens01:25

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MALDI-TOF MS has transformed clinical microbiology by offering a rapid and reliable method for pathogen identification. The traditional approach to microbial identification typically involves time-consuming culture techniques and biochemical tests, which can delay the initiation of appropriate antimicrobial therapy. MALDI-TOF MS avoids these delays by using characteristic ribosomal protein mass patterns of microbial cells, enabling accurate species-level identification within minutes.Principle...

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Fungal false positive in BioFire® FilmArray® analysis for bloodstream infection.

Osamu Imataki1, Ryoko Masumoto2, Masahiro Hamano2

  • 1Department of Laboratory Medicine, Kawasaki Medical School, General Medical Center, 2-6-1 Nakasange, Kita-district, Okayama city, Okayama 700-8505, Japan; Department of Laboratory Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki city, Okayama 701-0192, Japan.

Journal of Microbiological Methods
|December 27, 2025
PubMed
Summary

False positives in fungal detection using the BioFire FilmArray® blood culture identification panel 2 (BCID2) system were observed, particularly with Candida tropicalis. These results highlight limitations in PCR-based fungal identification, emphasizing the need for careful interpretation alongside clinical context.

Keywords:
Blood cultureBloodstream infectionFalse positiveFilmArray®MicrobiologyMultiplex molecular panelYeast

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Area of Science:

  • Clinical Microbiology
  • Molecular Diagnostics
  • Infectious Diseases

Background:

  • The BioFire FilmArray® system is an automated multiplex PCR tool for pathogen detection.
  • False positives can arise from cross-reactivity, contamination, or assay specificity issues.
  • This study focused on false-positive fungal results from the FilmArray® BCID2 panel.

Purpose of the Study:

  • To investigate the incidence and characteristics of false-positive fungal results using the FilmArray® BCID2 system.
  • To identify specific Candida species associated with false positives.
  • To explore potential causes for these false-positive findings.

Main Methods:

  • Collected prospective cases of suspected bloodstream infection over 12 months.
  • Utilized standard culture methods and mass spectrometry (VITEK MS PRIME) for fungal identification.
  • Compared results with the BioFire FilmArray® BCID2 panel.

Main Results:

  • Evaluated 454 blood culture samples, identifying 28 cases of fungemia (6.2%).
  • Observed 8 false-positive fungal results (1.8%), including Candida albicans and Candida tropicalis.
  • Four false-positive Candida tropicalis results were associated with co-detection of Candida parapsilosis.

Conclusions:

  • A significant rate of false-positive Candida results was identified with the FilmArray® BCID2 system.
  • Recurrent false positives involved Candida tropicalis, often alongside Candida parapsilosis.
  • Potential causes include non-viable DNA fragments and Candida parapsilosis/Candida tropicalis cross-reactivity, necessitating expert interpretation of results.