Rapid Detection of Pathogens and Resistance Genes in Positive Blood Cultures Using BioFire® FilmArray BCID2.

Abstract

Bloodstream infections cause significant morbidity and mortality, and rapid identification of the causative microorganisms, along with their antimicrobial resistance profiles, is crucial for appropriate treatment. Molecular diagnostic systems such as the BioFire FilmArray Blood Culture Identification 2 (BCID2) panel provide faster results than conventional culture-based methods. This study evaluated the performance of the BCID2 panel for rapid detection of microorganisms and antimicrobial resistance genes in 50 positive blood cultures collected at a university hospital between January 2023 and September 2025. All samples were obtained from peripheral blood cultures, and repeat or catheter-related cultures were excluded. Samples were analyzed using conventional culture methods, mass spectrometry-based identification, and automated antimicrobial susceptibility testing, in parallel with the BCID2 panel. Resistance genes detected by the panel were confirmed using polymerase chain reaction. At least one microorganism was detected in forty-seven samples (94%), showing strong agreement between molecular and culture-based methods. Complete concordance was observed for Escherichia coli and Pseudomonas aeruginosa, while Klebsiella pneumoniae showed slightly lower but acceptable agreement. Polymicrobial results were detected by BCID2 in 20 cases (40%). Detected resistance genes correlated well with phenotypic resistance results. However, the absence of clinical correlation data and repeat blood culture information limits the interpretation of these findings, particularly for coagulase-negative staphylococci. The BCID2 panel enables rapid and reliable identification of bloodstream pathogens and relevant resistance genes, serving as a valuable complement to conventional diagnostic methods when interpreted alongside clinical data.