title: Rapid Detection of Bloodstream Pathogens in Liver Transplantation Patients With FilmArray Multiplex Polymerase Chain Reaction Assays: Comparison With Conventional Methods.
abstract: BACKGROUND
  Bloodstream infection (BSI) is an important concern in transplant patients. Early intervention with appropriate antimicrobial therapy is critical to better clinical outcome; however, there is significant delay when conventional identification methods are used.
  
  
  METHODS
  We aimed to determine the diagnostic performance of the FilmArray Blood Culture Identification Panel, a recently approved multiplex polymerase chain reaction assay detecting 24 BSI pathogens and 3 resistance genes, in comparison with the performances of conventional identification methods in liver transplant (LT) patients. A total of 52 defined sepsis episodes (signal-positive by blood culture systems) from 45 LT patients were prospectively studied.
  
  
  RESULTS
  The FilmArray successfully identified 37 of 39 (94.8%) bacterial and 3 of 3 (100%) yeast pathogens in a total of 42 samples with microbial growth, failing to detect only 2 of 39 (5.1%) bacterial pathogens that were not covered by the test panel. The FilmArray could also detect additional pathogens in 3 samples that had been reported as having monomicrobial growth, and it could detect Acinetobacter baumannii in 2 samples suspected of skin flora contamination. The remaining 8 blood cultures showing a positive signal but yielding no growth were also negative by this assay. Results of MecA, KPC, and VanA/B gene detection were in high accordance. The FilmArray produced results with significantly shorter turnaround times (1.33 versus 36.2, 23.6, and 19.5 h; P < .05) than standard identification methods, Vitek II, and Vitek MS, respectively.
  
  
  CONCLUSIONS
  This study showed that the FilmArray appeared as a reliable alternative diagnostic method with the potential to mitigate problems with protracted diagnosis of the BSI pathogens in LT patients.
authors: Department of Medical Microbiology, Faculty of Medicine, Inonu University, Malatya, Turkey. Electronic address: baris.otlu@inonu.edu.tr.
authors: B
authors: B
authors: Otlu
authors: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Inonu University, Malatya, Turkey.
authors: Y
authors: Y
authors: Bayindir
authors: Department of Surgery, Liver Transplantation Institute, Faculty of Medicine, Inönü University, Malatya, Turkey.
authors: F
authors: F
authors: Ozdemir
authors: Department of Surgery, Liver Transplantation Institute, Faculty of Medicine, Inönü University, Malatya, Turkey.
authors: V
authors: V
authors: Ince
authors: Department of Medical Microbiology, Faculty of Medicine, Inonu University, Malatya, Turkey.
authors: S
authors: S
authors: Cuglan
authors: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Inonu University, Malatya, Turkey.
authors: M
authors: M
authors: Hopoglu
authors: Department of Medical Microbiology, Faculty of Medicine, Inonu University, Malatya, Turkey.
authors: Y
authors: Y
authors: Yakupogullari
authors: Department of Medical Microbiology, Faculty of Medicine, Ankara University, Ankara, Turkey.
authors: C
authors: C
authors: Kizilkaya
authors: Department of Medical Microbiology, Faculty of Medicine, Inonu University, Malatya, Turkey.
authors: C
authors: C
authors: Kuzucu
authors: Department of Medical Microbiology, Faculty of Medicine, Inonu University, Malatya, Turkey.
authors: B
authors: B
authors: Isık
authors: Department of Surgery, Liver Transplantation Institute, Faculty of Medicine, Inönü University, Malatya, Turkey.
authors: S
authors: S
authors: Yilmaz
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000175:diagnosis* / Q000382:microbiology; D001419:Bacteria / Q000302:isolation & purification; D001431:Bacteriological Techniques; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction / Q000379:methods*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult