The impact of a multiplex PCR-based blood culture identification panel (BCID2) on the management of sepsis in a pediatric population

Abstract:

Background: Rapid identification of pathogens in pediatric sepsis is critical for optimizing antimicrobial therapy and improving outcomes. This study aimed to evaluate the clinical impact of the multiplex PCR-based BioFire® Blood Culture Identification 2 (BCID2) Panel on the management of septicemia in children.
Methods: This retrospective cohort study was conducted at a university hospital in Türkiye. The study group included 38 pediatric patients (0-18 years) with positive blood cultures analyzed with the BCID2 Panel alongside conventional methods. The control group consisted of 38 historical patients for whom only conventional methods were used. We compared the time to pathogen identification, impact on antimicrobial therapy modification, antimicrobial therapy duration, and 30-day mortality between the groups.
Results: The mean time to final pathogen identification was approximately 57.5 hours shorter with the BCID2 Panel compared to conventional culture (45.0 vs 102.5 hours), although this difference was not statistically significant in our sample (p=0.241). In the study group, empirical antimicrobial therapy was modified in 55.3% of patients based on BCID2 results. A significant association was found between the detection of Acinetobacter baumannii by the panel and subsequent therapy modification (p=0.029). While the overall diagnostic agreement between BCID2 and culture was high (98%), significant discrepancies were noted in the detection of antimicrobial resistance genes, particularly for carbapenemases like KPC (p<0.01). There was no significant difference in the total duration of therapy or 30-day mortality between the groups (15.8% vs. 13.9%, p>0.05).
Conclusion: The BCID2 Panel significantly reduces the time to pathogen identification in pediatric sepsis, enabling earlier, targeted therapeutic adjustments. However, its limitations in detecting all relevant phenotypic resistance mechanisms underscore the continued necessity of conventional culture and susceptibility testing for comprehensive antimicrobial stewardship.

Biography:

Selim Oncel received his medical education from Ankara University Faculty of Medicine. He completed his specialization in Pediatrics and Child Health, as well as Family Medicine, at the Ministry of Health Ankara Training and Research Hospital, and received his fellowship in Pediatric Infectious Diseases from Ankara University Faculty of Medicine.

Following his positions as an Assistant Professor in the Department of Pediatrics and Child Health and as an Associate Professor in the Department of Pediatric Infectious Diseases at Kocaeli University Faculty of Medicine, he currently serves as a Professor Doctor at the same university. Dr. Oncel serves as the Head of the Department of Pediatric Infectious Diseases, a member of the Pre-graduate Education Committee, and a member of the Infection Control Committee at Kocaeli University Faculty of Medicine.

His research focuses on pediatric infectious diseases, the integration of generative artificial intelligence into pediatric infectious diseases, diagnostic methods, medical education, clinical decision support systems, and vaccinology.

He is also a former Eurovision contestant and a choral tenor. He produces and hosts a program on Radio Kİ, the radio station of Kocaeli University's Faculty of Communication. He teaches undergraduate and graduate courses on progressive rock and hybrid music genres at the university. He holds a 2nd Dan (Nidan) black belt in Aikido and has supervised aikido training programs at the university. Additionally, he holds international certificates from institutions such as Michigan, Yale, and Berklee in clinical skills, music theory, and music production