Title: Real-world assessment of rapid blood culture identification technology on emergency department blood culture callback process
Authors: Eleanor Carr, PharmD, Casey Boyer, PharmD, BCEMP, Sangeeta Sastry, MD, Jihye Kim, PharmD, BCPS, BCIDP
Learning Objective: Describe the clinical impact of BioFire® FilmArray® Blood Culture Identification 2 (BCID2) implementation on readmission rate for patients with coagulase-negative Staphylococcus (CoNS) -positive blood cultures after discharge from the emergency department (ED).
Self-Assessment Question:
What outcome significantly changed after implementation of BCID2 for patients who returned to the ED with coagulase‑negative Staphylococcus–positive blood cultures?
- Readmission rate
- Hospital length of stay
- Prolonged antibiotic administration
- None
Background:
The objective of the study is to compare the callback readmission rates in patients discharged from the ED with CoNS blood cultures prior to and after BCID2 implementation at our institution on March 13,2023.
Methods:
This is a single‑center, retrospective, pre-post quasi-experimental study of adult patients (≥18 years) with at least one positive blood culture for CoNS and discharged from the ED between January 1, 2022, and August 31, 2025. Patients with polymicrobial blood cultures were excluded. Outcomes included hospital readmission rates, empiric CoNS antibiotic initiation upon readmission, and antibiotic duration greater than 72 hours, with statistical analyses performed using JMP® software.
Results:
A total of 55 patients (pre-BCID2, n=31; post-BCID2, n=24) met inclusion criteria. Readmission rate after BCID2 implementation was not statistically different between the two groups (pre-BCID2: n=18/32 (58.1%) vs post-BCID2: n=12/24 (50%), p = 0.5945). Implementation of BCID2 was associated with a significant decrease in antibiotic initiation upon readmission (pre-BCID2: n=14/18, (77.8%) vs post-BCID2: n=4/12 (33.3%), p = 0.0243). Additionally, prolonged use of empiric antimicrobials was significantly higher in pre-BCID2 group compared to post-BCID2 group during further evaluation upon readmission (pre-BCID2: n=5/18 (27.8%) vs post-BCID2: n=0/12 (0%), p = 0.0455).
Conclusion:
The implementation of BCID2 did not significantly reduce readmission rates among patients with CoNS‑positive blood cultures at our institution. However, BCID2 was associated with a statistically significant reduction in rates of antibiotic initiation and prolonged duration of therapy. These findings highlight an opportunity to further characterize re-admitted patients and develop an institution‑specific protocol to optimize and standardize ED blood culture callback processes and resource utilization.
