{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:24:13Z","timestamp":1788269053236,"version":"build-2803163510"},"reference-count":20,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"bioM\u00e9rieux PERI- & POST-Launch Study Program","award":["BFD-BC-24-006 Study"],"award-info":[{"award-number":["BFD-BC-24-006 Study"]}]},{"name":"Ratchadapisek Sompoch Research Funds, Graduate Affairs, Faculty of Medicine, Chulalongkorn University","award":["GA68\/040"],"award-info":[{"award-number":["GA68\/040"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Conventional blood culture is the gold standard for pathogen identification for patients with sepsis, but its lengthy turnaround time\u2014encompassing initial bottle incubation and subsequent phenotypic testing\u2014may delay appropriate therapy. The multiplex PCR-based BIOFIRE Blood Culture Identification 2 (BCID2) panel enables earlier pathogen identification and improves patient outcomes. This study aimed to assess the impact of implementing the BCID2 panel versus conventional culture methods on clinical and microbiological outcomes in hospitalized pediatric patients. This case-control cohort study included 150 retrospective and 150 prospective hospitalized patients with positive blood cultures evaluated via parallel BCID2 and conventional culture. The antibiotic stewardship program (ASP) team provided antimicrobial recommendations based on BCID2 results, with final treatment decisions deferred to the attending physicians. Time to targeted therapy was calculated from the initial antibiotic dose\u2014or blood culture collection if the patient was already on antibiotics\u2014to the start of targeted antimicrobial therapy. The median age in the BCID2 group was significantly higher than the pre-BCID2 group, 2.8 vs 1.7 years, respectively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.032). While 18 pathogens among the 150 BCID2 cases (12%) were not identified due to being off-panel targets, BCID2 results prompted antimicrobial modification in 28.8% of the remaining cases (38\/132). Median time to targeted therapy was 17.0 hours (IQR 9.6\u201334.2) with BCID2 group versus 24.2 hours (IQR 16.3\u201352.2) with conventional culture (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.014). On multivariable logistic regression analysis, the BCID2 intervention remained an independent and significant predictor of achieving rapid antimicrobial optimization (aOR 2.68; 95% CI 1.17\u20136.14;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.019). BCID2 implementation paired with an active ASP optimizes antimicrobial use in pediatric bacteremia through accelerated targeted therapy. However, a negative BCID2 result requires nuanced clinical interpretation due to the possible presence of off-panel pathogens or rare genotype\u2013phenotype discrepancies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>Bloodstream infection (BSI) remains a leading cause of pediatric morbidity and mortality worldwide. While conventional blood culture is the gold standard, its lengthy turnaround time often delays life-saving therapy. Rapid diagnostic testing (RDT), such as the BIOFIRE Blood Culture Identification 2 (BCID2) panel, is now recommended alongside antimicrobial stewardship programs (ASPs) to optimize clinical management. Our study demonstrates that implementing multiplex PCR-based RDT significantly improves patient outcomes by accelerating the time to targeted therapy. Furthermore, the integration of RDT into an ASP was associated with a significant reduction in both 30-day mortality and hospital length of stay. In conclusion, RDT-guided stewardship serves as both a vital diagnostic tool and a clinical engine that transforms the management of pediatric BSI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.01571-26","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T13:02:07Z","timestamp":1786021327000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Implementation of multiplex PCR-based blood culture identification among hospitalized pediatric patients at a tertiary care center"],"prefix":"10.1128","volume":"14","author":[{"given":"Pongsatorn","family":"Sripol","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/028wp3y58","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pediatrics, Faculty of Medicine, Chulalongkorn University","place":["Bangkok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pintip","family":"Suchartlikitwong","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/028wp3y58","id-type":"ROR","asserted-by":"publisher"}],"name":"Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University","place":["Bangkok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Napawan","family":"Punakabutra","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/028wp3y58","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology, Faculty of Medicine, Chulalongkorn University","place":["Bangkok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0913-1723","authenticated-orcid":true,"given":"Jiratchaya","family":"Sophonphan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/028wp3y58","id-type":"ROR","asserted-by":"publisher"}],"name":"Research Affairs, Faculty of Medicine, Chulalongkorn University","place":["Bangkok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Ma Kang Li","sequence":"additional","affiliation":[{"name":"Medical Affairs, bioM\u00e9rieux Asia Pacific Pte. Ltd.","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6965-5537","authenticated-orcid":true,"given":"Suvaporn","family":"Anugulruengkitt","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/028wp3y58","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pediatrics, Faculty of Medicine, Chulalongkorn University","place":["Bangkok, Thailand"]},{"id":[{"id":"https:\/\/ror.org\/028wp3y58","id-type":"ROR","asserted-by":"publisher"}],"name":"Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University","place":["Bangkok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy1030"},{"key":"e_1_3_4_3_2","unstructured":"World Health Organization. 2023. Sepsis. World Health Organization Geneva.. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/sepsis."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32989-7"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw118"},{"key":"e_1_3_4_6_2","unstructured":"bioM\u00e9rieux. 2023. BIOFIRE BCID2 panel: bioM\u00e9rieux. Available from: https:\/\/www.biomerieux.com\/us\/en\/our-offer\/clinical-products\/biofire-blood-culture-identification-2-panel.html"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00996-16"},{"key":"e_1_3_4_8_2","unstructured":"Department of Medical Sciences Ministry of Public Health. National antimicrobial resistant surveillance center dashboard. Available from: https:\/\/narst.dmsc.moph.go.th\/Dashborad. Retrieved 03 Apr 2026."},{"key":"e_1_3_4_9_2","volume-title":"Performance standards for antimicrobial susceptibility testing","author":"Clinical and Laboratory Standards Institute","year":"2024","unstructured":"Clinical and Laboratory Standards Institute. 2024. CLSI supplement M100. In Performance standards for antimicrobial susceptibility testing, 34th ed. Clinical and Laboratory Standards Institute, Wayne, PA.","edition":"34"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics11040453"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa932"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03570.x"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ447"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.3758\/bf03193146"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piw047"},{"key":"e_1_3_4_16_2","unstructured":"StataCorp. 2025. Stata statistical software: release 19. College Station TX. StataCorp LLC."},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.00122-22"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pathol.2021.02.016"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae234"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00543-21"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.00429-21"}],"container-title":["Microbiology Spectrum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.01571-26","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.01571-26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:11:51Z","timestamp":1788268311000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/spectrum.01571-26"}},"subtitle":[],"editor":[{"given":"Melissa R.","family":"Gitman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":20,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9,1]]}},"alternative-id":["10.1128\/spectrum.01571-26"],"URL":"https:\/\/doi.org\/10.1128\/spectrum.01571-26","relation":{},"ISSN":["2165-0497"],"issn-type":[{"value":"2165-0497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]},"assertion":[{"value":"2026-05-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01571-26"}}