Role of BioFire multiplex PCR in rapid detection of bloodstream pathogens in hematological malignancies

Background and aim Bloodstream infection (BSI) causes significant patient morbidity and mortality, especially in patients with hematological malignancies. This study evaluates the role of BioFire in the rapid detection of bloodstream pathogens in hematological malignancies and identifies the bacterial and fungal species causing BSI. In addition, it evaluates the effect of prophylactic antimicrobials on developing multidrug-resistant bacteria and identifies common carbapenem-resistant genes using lateral flow assay. Patients and methods This hospital-based descriptive cross-sectional study included 261 patients, who were admitted to the Clinical Hematology Department from January 2020 to February 2022. All study group patients were subjected to full history taking, clinical examination, and laboratory investigations. Blood cultures were inoculated into BACT/ALERT culture bottles. Identification of the isolated organism was done by VITEK2, BioFire FilmArray Blood Culture Identification Panel, and conventional identification. Results The result revealed that the incidence of BSIs among the studied population was 20.7% of the total 261 cases. Gram-negative bacteria were the main organisms responsible for the BSIs, which account for 57.6%, while Gram-positive bacteria accounted for 35.2% and fungi accounted for 7.4%. The results of the BioFire FilmArray Blood Culture Identification Panel in comparison to VITEK2 and conventional identification of pathogen show fairly accepted sensitivity and specificity in diagnosis of common BSIs. Conclusion BSI is fairly common in patients with hematological malignancies. Early identification and prompt intervention may affect patient's outcome. As regards high cost of the test, rapid diagnostic techniques have a clinical impact if the reporting is coupled with antimicrobial stewardship. Keywords: Blood Culture Identification, bloodstream infection, FilmArray, hematological malignancies, multiplex PCR