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Life sciences · Journal article
Annals of Medicine · November 1, 2026
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Background. Bloodstream infections (BSI) frequently occur in critically ill patients and remain associated with high mortality rates.Methods. A prospective, observational, multicenter investigation was carried out through the MULTI-SITA platform to evaluate how the addition of a molecular syndromic panel, the BIOFIRE® Blood Culture Identification 2 (BCID2) Panel (BCID2 panel), to conventional blood culture diagnostics influenced key clinical endpoints and antimicrobial use. The primary endpoint was all-cause mortality within 30 days following the onset of BSI.Results. Among the 126 included critically ill patients with BSI, multivariable analysis identified SOFA score (hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.09-1.34, p < 0.001), other concomitant infections requiring antibiotic therapy (HR 2.61, 95% CI 1.18-5.79, p = 0.018), and BSI caused by Acinetobacter spp. (HR 4.35, 95% CI 1.10-17.18, p = 0.036), Staphylococcus aureus (HR 3.38, 95% CI 1.26-9.08, p = 0.016), or Stenotrophomonas maltophilia (HR 15.97, 95% CI 2.43-104.54, p = 0.004) as associated with increased mortality, while no association was observed between use of the BCID2 panel and mortality (HR 0.97, 95% CI 0.42-2.25, p = 0.941). In secondary analyses, the use of the BCID2 panel resulted in more events of either early antimicrobial de-escalation or initiation of appropriate therapy at day one from BSI onset compared with a standard blood culture workflow (55.6% vs. 31.7%, p = 0.015).Conclusion. In critically ill patients with BSI, implementation of a molecular syndromic panel influenced antimicrobial management decisions without affecting mortality. Additional investigations are warranted to clarify the long-term antimicrobial stewardship implications of treatment strategies guided by molecular syndromic panels-based diagnostic workflows.