{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:14:48Z","timestamp":1784556888938,"version":"3.55.0"},"reference-count":24,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Bloodstream infections (BSIs) carry high mortality, and any delay in initiating optimal antimicrobial therapy worsens outcomes. Syndromic multiplex-PCR panels applied to signal-positive blood cultures markedly shorten time-to-identification but are expensive and report results in a strictly qualitative format. We describe twenty-two months of real-world BioFire FilmArray Blood Culture Identification 2 (BCID2) testing in a southern Italian hospital, focusing on pathogen epidemiology, resistance-gene detection, and the economic and interpretive trade-offs of the assay. Methods: We retrospectively reviewed all BCID2 runs performed on signal-positive blood-culture bottles at P.O. \u201cVito Fazzi\u201d (ASL Lecce) from July 2024 to April 2026. Each run was classified as single-pathogen-positive, polymicrobial (co-infection)-positive, or negative (no on-panel target). Resistance determinants were tabulated by year and by presumptive carrier. A direct-cost analysis was performed at a reagent cost of \u20ac250 per test. Results: Of 498 runs, 401 (80.5%) yielded at least one on-panel target (330 single-pathogen, 71 polymicrobial), whereas 97 (19.5%) were negative. Among 526 organism detections, Gram-positive (48.9%) and Gram-negative (45.8%) bacteria predominated; Staphylococcus spp., Escherichia coli and the Klebsiella pneumoniae group were most frequent. Resistance determinants (n = 244) were dominated by mecA\/C, CTX-M and KPC. Co-infections (17.7% of positives) frequently prevented unambiguous attribution of a resistance gene to a specific co-detected organism. Total reagent expenditure was \u20ac124,500, of which \u20ac24,250 (19.5%) was spent on negative results. Conclusions: BCID2 delivered rapid, broad pathogen and resistance-gene detection in a high-resistance setting. Its qualitative-only output, the difficulty of attributing a resistance gene to a specific organism in polymicrobial samples, and the cost of negative results nonetheless argue for diagnostic-stewardship gating, semiquantitative reporting, and local validation of complementary and lower-cost assays.<\/jats:p>","DOI":"10.3390\/diagnostics16142252","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T02:32:08Z","timestamp":1784514728000},"page":"2252","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multiplex-PCR Identification of Positive Blood Cultures: Pathogen Epidemiology, Resistance Determinants, and the Economic and Interpretive Cost of Qualitative Rapid Diagnosis"],"prefix":"10.3390","volume":"16","author":[{"given":"Laura","family":"Lupo","sequence":"first","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Serafini","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1441-6205","authenticated-orcid":false,"given":"Daniela","family":"Chirizzi","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Spedicato","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Bianco","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"},{"name":"Department of Experimental Medicine (DiMeS), University of Salento, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Pisan\u00f2","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Rita","family":"Orsi","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Moschettini","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcella","family":"Marullo","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Sorge","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosanna","family":"Bruno","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Panico","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvana","family":"Arnesano","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Simone","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana","family":"Corciulo","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Pico","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Pagano","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia","family":"Fulceri","sequence":"additional","affiliation":[{"name":"UOC Hospital Pharmacy, P.O. Vito Fazzi, ASL Lecce, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Apruzzi","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"},{"name":"Dipartimento di Medicina Sperimentale, Universit\u00e0 degli Studi della Campania \u201cLuigi Vanvitelli\u201d, 80138 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0395-7962","authenticated-orcid":false,"given":"Anna De","family":"Filippis","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Sperimentale, Universit\u00e0 degli Studi della Campania \u201cLuigi Vanvitelli\u201d, 80138 Napoli, Italy"},{"name":"UOC Microbiologia e Virologia, AOU \u201cLuigi Vanvitelli\u201d, 80138 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1576-6290","authenticated-orcid":false,"given":"Massimiliano","family":"Galdiero","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Sperimentale, Universit\u00e0 degli Studi della Campania \u201cLuigi Vanvitelli\u201d, 80138 Napoli, Italy"},{"name":"UOC Microbiologia e Virologia, AOU \u201cLuigi Vanvitelli\u201d, 80138 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1297-2598","authenticated-orcid":false,"given":"Francesco","family":"Broccolo","sequence":"additional","affiliation":[{"name":"UOSD, Microbiologia e Virologia Universitaria, P.O. \u201cVito Fazzi\u201d, ASL Lecce, 73100 Lecce, Italy"},{"name":"Department of Experimental Medicine (DiMeS), University of Salento, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e01891-22","DOI":"10.1128\/jcm.01891-22","article-title":"Multicenter Evaluation of the BIOFIRE Blood Culture Identification 2 Panel for Detection of Bacteria, Yeasts, and Antimicrobial Resistance Genes in Positive Blood Culture Samples","volume":"61","author":"Rhoads","year":"2023","journal-title":"J. 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