BCID2 Shortens Time to Effective Antimicrobial Changes

Adding the BioFire Blood Culture Identification 2 (BCID2) Panel (bioMérieux) to standard testing and antimicrobial stewardship shortened the time to first effective antimicrobial modification in hospitalized adults with positive blood cultures, according to a randomized controlled trial published online in Clinical Infectious Diseases.

The prospective, open-label, single-center trial was conducted at Korea University Anam Hospital from June through October 2025. Investigators randomized 428 patients 1:1, with 418 included in the modified intention-to-treat analysis: 208 received standard blood culture, organism identification, and phenotypic antimicrobial susceptibility testing, and 210 received the same testing plus BCID2 multiplex PCR. Both groups were managed under the same antimicrobial stewardship program.

The primary outcome was time from randomization to the first effective escalation, de-escalation, or lateral antimicrobial change within 120 hours. Median time was 23.2 hours with multiplex PCR and 64.5 hours with standard care, a 41.3-hour difference (P<.001). The median was also shorter with multiplex PCR across all prespecified subgroups, including laboratory hours, pathogen type, ICU status, resistance status, and modification type.

At 12 hours, 86.2% of patients in the multiplex PCR arm and 65.9% in the standard-care arm were receiving effective therapy (P<.001), with significantly higher proportions through 120 hours. Persistent bloodstream infection occurred in 5.7% versus 11.5% (P=.038). However, 30-day mortality (13.8% vs 14.4%; P=.889) and hospital length of stay (median, 14 vs 13 days; P=.739) did not differ significantly.

The authors noted that institution-specific laboratory workflows may limit generalizability and that the trial was not powered to detect differences in mortality or length of stay. The study was investigator initiated and supported by bioMérieux, which the authors said had no role in study design, data collection or interpretation, or the decision to publish.

Source: Kim KJ, Yoon YK, Kim JY, Kim MJ, Sohn JW, Nam MH. Clinical impact of rapid molecular diagnosis of bloodstream infections: a randomized controlled trial. Clin Infect Dis. Published online August 20, 2026. doi:10.1093/cid/ciag511