Diagnostic Accuracy of the Biofire FilmArray Blood Culture Identification 2 (BCID2) for Bloodstream Infections in...

Bloodstream infections are a leading global cause of mortality and morbidity. Timely and accurate diagnosis improves outcomes, especially in resource-limited settings. Rapid and accurate diagnostic tools are essential for effective treatment, particularly in resource-limited settings. Our study aimed to evaluate the diagnostic performance of the BCID2 assay, comparing its effectiveness to the VITEK2 at a routine lab in Limpopo, South Africa, where alternative assays are necessary to overcome resource unavailability in areas located further away from major laboratories.

This cross-sectional study was conducted from August to December 2023. A total of 247 positive blood culture bottles were tested using both BCID2 and VITEK2 systems. Statistical analysis, including specificity, sensitivity, and accuracy, was calculated using Medcalc and SPSS.

The BCID2 panel demonstrated a sensitivity, specificity, and accuracy of 95.7%, 95.5%, and 96%, respectively. Of the samples, 72% (179/247) were monomicrobial and 28% (68/247) were polymicrobial, with a total of 16 off-panel microorganisms identified across both groups. blaCTX-M was the most frequent Gram-negative resistance gene detected (55.2%, 80/145), while blaVIM was the least common (0.7%, 1/145).

The study concluded that the BCID2 assay demonstrates excellent diagnostic accuracy, with sensitivity, specificity, and overall accuracy rates above 95%. Its ability to rapidly detect bloodstream infections and antimicrobial resistance markers makes it a highly effective tool, particularly in resource-limited settings like Limpopo, South Africa, where timely and accurate diagnosis is crucial to improving patient outcomes.