BioFire® machine, great teamwork help patients quickly receive optimal therapy
The device in Munson Medical Center’s Microbiology Lab resembles a bread machine connected to a computer – and it is helping improve the quality of care for patients.
Instead of mixing yeast and flour, the BioFire® machine’s design and programming allows it to quickly detect yeasts, fungi, viruses and dangerous bacteria brewing within the sickest patients to help physicians, pharmacists and medical technologists team up to give patients better outcomes and in many cases save lives.
“It’s a little machine with a lot of power,” said Anne Gore, lead medical technologist in the Microbiology Lab. The machine works by taking a prepared sample of blood, spinal fluid, or respiratory fluid and amplifying its DNA. It compares the DNA with pathogens in its data base to identify the organism.
Since implementing blood testing with the machine in December, more than 100 patients have been helped through compressing the time organisms are identified from days to hours. Munson Medical Center is the only hospital in northern Michigan with the device.
Infectious disease pharmacy resident Derek VanderHorst, Pharm.D., was familiar with literature about the device. He implemented plans with medical technologists to start using the machine for blood sampling to better speed therapy for patients.
“The use of this machine is starting to become standard practice because it is improving outcomes in our patients,” he said. “The vast majority of the institutions that use these machines are the large academic centers, so there is very little information on whether or not it is possible to do something like this in a community hospital like Munson Medical Center. We’re doing it.”
Typically when a patient arrives in the Emergency Department, one of the first things a physician does is order a blood test. That blood is sent to the Microbiology Lab in a test tube and placed in a machine designed to detect a pathogen. If the machine registers a positive find for a blood sample, a medical technologist takes a drop of blood and does a quick smear on a slide to confirm the sample is positive.
Before the hospital purchased the BioFire device, the next step would be to grow the pathogen in a culture plate to identify it. Meanwhile, physicians would start broad antibiotic medication treatment, but would not know the specific “germ” at the root of a patient’s condition or if it is resistant to the current antibiotics.
For septic patients, those with a blood stream infection, every hour without appropriate therapy can increase their mortality risk by 7 percent.
“Traditionally when you get a positive blood culture, we would get a gram stain, and we wouldn’t have identification or sensitivities which give us the effective therapy until 48 hours later,” said Nicholas Torney, Pharm.D., an infectious disease pharmacist at the hospital. “This machine is a time saver, and then it’s a life saver.”
The first day the machine was used on a patient’s blood sample it detected bacteria resistant to certain types of antibiotics. This allowed the appropriate medication to be used 48 hours faster than traditional methods.
VanderHorst points to efforts that saved one extremely sick patient whose test revealed a yeast infection in the blood. When he learned of the yeast detection, VanderHorst spoke with an infectious disease physician about patient. They started initial treatment, but also worked with the Lab to get a sample of the patient’s blood into the BioFire machine. The device helped them hone in on the specific organism and target it effectively.
“We wouldn’t have been able to do that without this machine. It would have taken us days,” he said. “So this patient would have wound up without good therapy for days and they got it within hours. That was a huge victory. The patient had a good outcome.” V
VanderHorst said patients benefit because the hospital’s pharmacists, medical technologists, and physicians collaborate for the best outcome. Instead of only putting a test result on a patient’s chart, medical technologists notify the pharmacist of the result and the pharmacist contacts the physician. Together they discuss the appropriate medication to target the organism.
“None of this would be possible without the collaboration between these three groups,” VanderHorst said. “It’s exciting because we are getting patients on optimal therapy much, much faster.”
Learn more about the hospital's quality efforts.