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

IF 2.5 4区生物学 Q4 BIOCHEMICAL RESEARCH METHODS

Journal of microbiological methods Pub Date : 2026-02-01 Epub Date: 2025-12-25 DOI:10.1016/j.mimet.2025.107380

Osamu Imataki , Ryoko Masumoto , Masahiro Hamano , Masaki Ishimatsu , Shin-ichiro Suemori , Takayuki Tsujioka , Masayo Tamura , Akira Kitanaka

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引用次数: 0

Abstract

Background

The BioFire FilmArray® system is an automated multiplex PCR tool for detecting pathogens in clinical samples. False positives occasionally occur due to cross-reactivity, contamination, or assay specificity issues. This study investigated false-positive fungal results in FilmArray® blood culture identification panel 2 (BCID2) detection system.

Method

We collected the continuous cases in which bloodstream infection (BSI) was suspected in our institute for 12 months, from April in 2024 to March in 2025. We routinely used Bactec FX culture system (Beckton Dickinson) with BD BACTEC culture bottles. Alongside, we identified fungus using standard culture method and matrix-assisted laser desorption ionization-time of flight mass spectrometry (biomerieux, VITEK MS PRIME).

Results

We evaluated continuous 454 blood culture positive sample. Average blood culture sampling were totally 5357 samples per year (44.3/1000 patients days) of blood cultures during our study period. We collected 28 cases of fungemia among totally recruited 454 samples (6.2 %, 28/454). Accordance of blood culture and FilmArray® were 50.0 % (14 samples). We observed eight false positive samples (1.8 %. 8/454) as fungemia out of total 454 samples, in where one false organism was Candida albicans and seven were Candida tropicalis. In the cases of four false Candida tropicalis samples, the FilmArray® reported the two fungal combination, Candida parapsilosis and Candida tropicalis.

Conclusion

Our investigation revealed a substantial incident of false positive of Candida. The study highlights recurrent false positives of Candida tropicalis, often detected alongside Candida parapsilosis. The main cause of the detection of false positive organism in BCID2 including Candida spp. has been reported as contamination or technical errors. We speculated that our observation could be derived from the non-viable DNA fragments (Candida albicans) contained in the blood culture media and cross-reaction of Candida parapsilosis with Candida tropicalis. We should remember these FilmArray® assay limitations linked to non-viable DNA contamination and high reactivity of sensitive PCR analysis. False positive results for Candida spp. in BCID2 assays require careful interpretation with microbiological expertise. Clinical decisions should be guided by the patient's overall context. Further research is necessary to assess the accuracy of fungal BSI. (341/500 words).

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BioFire®FilmArray®血液感染分析真菌假阳性。

背景：BioFire FilmArray®系统是一种用于检测临床样品中病原体的自动多重PCR工具。由于交叉反应性、污染或测定特异性问题，偶尔会出现假阳性。本研究调查了FilmArray®血培养鉴定面板2 （bccid2）检测系统中真菌假阳性结果。方法：收集我院自2024年4月至2025年3月连续12个 月疑似血流感染（BSI）病例。我们常规使用Bactec FX培养系统（Beckton Dickinson）和BD Bactec培养瓶。此外，我们使用标准培养法和基质辅助激光解吸电离飞行时间质谱法（biomerieux, VITEK MS PRIME）鉴定真菌。结果：对连续454例血培养阳性标本进行评价。在我们的研究期间，平均血液培养采样总数为5357份/年（44.3/1000患者天）。在共454份样本中，我们收集到28例真菌血症（6.2 %,28/454）。血培养与FilmArray®的符合率为50.0 %（14份）。我们观察到8个假阳性样本（1.8 %）。8/454)为真菌病，其中1个假菌为白色念珠菌，7个为热带念珠菌。在4例假热带假丝酵母样本中，FilmArray®报告了两种真菌组合，假丝酵母副假丝酵母和热带假丝酵母。结论：我们的调查发现了一起假阳性念珠菌的重大事件。该研究强调了热带念珠菌的复发性假阳性，通常与假丝酵母菌伴假丝酵母菌病一起检测。据报道，在bccid2中检出假阳性生物（包括念珠菌）的主要原因是污染或技术错误。我们推测，我们的观察结果可能来源于血液培养基中含有的非活的DNA片段（白色念珠菌）和副假丝酵母与热带假丝酵母的交叉反应。我们应该记住这些FilmArray®检测限制与非活的DNA污染和敏感PCR分析的高反应性有关。假阳性结果念珠菌在bccid2检测需要仔细解释与微生物专业知识。临床决策应以患者的整体情况为指导。真菌BSI的准确性有待进一步研究。(341/500的话)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of microbiological methods 生物-生化研究方法

CiteScore

4.30

自引率

4.50%

发文量

151

审稿时长

29 days

期刊介绍： The Journal of Microbiological Methods publishes scholarly and original articles, notes and review articles. These articles must include novel and/or state-of-the-art methods, or significant improvements to existing methods. Novel and innovative applications of current methods that are validated and useful will also be published. JMM strives for scholarship, innovation and excellence. This demands scientific rigour, the best available methods and technologies, correctly replicated experiments/tests, the inclusion of proper controls, calibrations, and the correct statistical analysis. The presentation of the data must support the interpretation of the method/approach. All aspects of microbiology are covered, except virology. These include agricultural microbiology, applied and environmental microbiology, bioassays, bioinformatics, biotechnology, biochemical microbiology, clinical microbiology, diagnostics, food monitoring and quality control microbiology, microbial genetics and genomics, geomicrobiology, microbiome methods regardless of habitat, high through-put sequencing methods and analysis, microbial pathogenesis and host responses, metabolomics, metagenomics, metaproteomics, microbial ecology and diversity, microbial physiology, microbial ultra-structure, microscopic and imaging methods, molecular microbiology, mycology, novel mathematical microbiology and modelling, parasitology, plant-microbe interactions, protein markers/profiles, proteomics, pyrosequencing, public health microbiology, radioisotopes applied to microbiology, robotics applied to microbiological methods,rumen microbiology, microbiological methods for space missions and extreme environments, sampling methods and samplers, soil and sediment microbiology, transcriptomics, veterinary microbiology, sero-diagnostics and typing/identification.