Significance of Film Array Blood Culture Identification (BCID2) Panel for the Detection of Carbapenem-Resistant Acinetobacter baumannii complex Septicemia among Immunocompromised Patients: A Case Series Analysis

Abstract

Background: Acinetobacter baumannii (A. baumannii) complex is a notorious nosocomial pathogen causing infections in immunocompromised patients, often exhibiting multidrug resistance (MDR) due to intrinsic resistance mechanisms and virulence factors. This case series aimed to understand the significance of the Blood Culture Identification 2 (BCID 2) film array panel for detecting MDR A. baumannii complex bacteraemia in immunocompromised patients for timely specific management.

Case descriptions: Four cases were presented, including 3 burn injury cases and 1 autoimmune patient. All patients had comorbidities and developed septicaemia during their hospital stay. Blood cultures from central and peripheral lines were positive for MDR A. baumannii complex, with isolates most commonly being intermediate to only colistin and polymyxin B. Simultaneously, VITEK 2 findings revealed the presence of carbapenemase phenotypes. The BCID 2 panel detected the NDM gene in A. baumannii complex isolates from two patients. Furthermore, a combination therapy of intravenous polymyxin B and meropenem was initiated, leading to clinical improvement and timely recovery in these 2 cases, highlighting the need for specific genotypic level detection of resistant genes by the BCID 2 panel.

Conclusion: This case series highlights the significance of the BCID 2 panel in rapidly identifying MDR A. baumannii complex and associated resistance genes, facilitating timely and appropriate antimicrobial therapy in immunocompromised patients with septicaemia.