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Patient guide · Infectious diseases

BioFire multiplex PCR testing, syndromic PCR panels for GI, respiratory, meningitis and bloodstream infection.

BioFire is a fast PCR test that looks for dozens of infections at once from a single sample. Results come back in about an hour. Panels cover gut, chest, brain, and bloodstream infections.

Read the key facts

Reviewed by Pulse Atlas Editorial Board, · Published 2026-07-30 · Next review 2027-07-30 · 6 min read

A microbiology scientist loading a BioFire multiplex PCR cartridge

Key facts

  • 01

    What it is

    One test, many bugs. It reads pathogen DNA or RNA from a single sample in about an hour.

  • 02

    Available panels

    Gastrointestinal, respiratory, meningitis / encephalitis, and blood-culture identification.

  • 03

    Higher sensitivity

    Detects many pathogens missed by culture, particularly viruses and fastidious bacteria.

  • 04

    Same-day, actionable

    Result reported to the clinician within an hour of the sample loading — treatment can start the same visit.

  • 05

    Viruses, bacteria, parasites

    One cartridge run covers all three classes of organism — no separate assays needed.

  • 06

    Clinical interpretation

    Read alongside history and examination — the panel does not test antimicrobial susceptibility.

How it works

From clinical decision to result — what happens, in order.

The pathway from the first clinical assessment to a same-day, actionable result.

  1. 01

    Before

    Consult specialist, A&E or GP

    A clinician decides the syndromic picture — GI, respiratory, meningitis or bloodstream — before any sample is taken.

  2. 02

    Before

    Choose the appropriate panel

    Panel is selected against the presentation: diarrhoea, respiratory illness, suspected meningitis, or positive blood culture bottle.

  3. 03

    Before

    Sample collection

    Stool, respiratory swab, cerebrospinal fluid, or a positive blood-culture aliquot — a single sample, taken once.

  4. 04

    The run

    Sample loaded into cartridge

    The cartridge is closed and inserted into the BioFire instrument — no manual pipetting once sealed.

  5. 05

    The run

    Automated PCR run (~1 hour)

    Nested multiplex PCR runs against every target on the panel simultaneously — hands-off.

  6. 06

    After

    Result reported to clinician

    A structured report of every target lists as detected or not detected, released to the requesting clinician.

  7. 07

    After

    Clinical decision on treatment

    The clinician acts — targeted antimicrobials, isolation, or de-escalation from empirical cover.

End-to-end time: about one hour from cartridge loading to result.

The panels

What each BioFire panel actually detects.

Four core syndromic panels, plus a limited resistance-marker read. Each panel answers a specific clinical question — read them alongside the presentation.

  • GI panel

    Salmonella, Shigella, Campylobacter, C. difficile, Norovirus and other common enteric pathogens.

  • Respiratory panel

    Influenza A/B, RSV, SARS-CoV-2, adenovirus, Mycoplasma pneumoniae and other viral / atypical causes.

  • Meningitis panel

    S. pneumoniae, N. meningitidis, HSV 1/2, VZV, enteroviruses and other CSF pathogens.

  • Blood culture ID panel

    Staphylococci, Streptococci, Gram-negatives and Candida identified from positive blood-culture bottles.

  • Antimicrobial resistance markers

    Limited resistance panel: mecA, KPC, NDM, vanA/B — helpful, not a full sensitivity profile.

  • Rapid rule-out

    Quickly excludes common viral and bacterial causes so empirical antibiotics can be de-escalated.

  • High negative predictive value

    A negative panel is a strong signal against the pathogens on that panel — useful for stewardship.

  • Red flag: positive panel + sepsis or meningism — urgent IV antibiotics

    Do not wait for confirmation — start IV antibiotics per local protocol immediately.

Next steps

What happens once the result is in.

Every positive result triggers a defined pathway — targeted treatment, isolation, notification and follow-up.

  • Targeted antimicrobial therapy

    Empirical cover is narrowed to the detected organism — right drug, right dose, right duration.

  • Isolation and infection-control notification

    Side-room, PPE, and the infection-control team informed in line with local policy.

  • Contact tracing

    Norovirus, C. difficile and meningitis pathogens trigger contact-tracing pathways.

  • Public Health England / UKHSA notification

    Notifiable organisms are reported to public-health authorities as required by law.

  • Repeat testing after treatment

    C. difficile clearance and TB monitoring may require repeat samples — BioFire itself is not a test-of-cure.

  • Culture and sensitivity to guide narrow-spectrum

    Conventional culture continues in parallel to give a full antimicrobial-sensitivity profile.

  • Immunosuppression pathway

    Transplant, chemotherapy or biologic patients are escalated to the appropriate specialist team.

  • Multi-disciplinary team review

    Complex or resistant cases go to microbiology / infectious diseases MDT for a treatment plan.

Sources

The guidance this page draws on.

UK national guidance and international specialist bodies for antimicrobial stewardship and microbiology.

Selection criteria

Only current, peer-reviewed guidance from named specialist bodies.

A microbiology laboratory bench with a BioFire multiplex PCR instrument
Clinically reviewed

Red flags

When BioFire alone isn’t enough.

The clinical scenarios where treatment cannot wait for a result — and where a specific pathway takes over.

  • Meningitis

    Fever, headache, photophobia and neck stiffness — start empirical IV antibiotics before results.

  • Sepsis

    Sepsis-6 bundle within one hour — BioFire result does not delay antibiotics or fluids.

  • Neonatal infection

    Any neonate with suspected sepsis or meningitis is a paediatric emergency.

  • Immunosuppressed patient

    Transplant, chemotherapy, biologic or HIV patients need infectious-diseases input, not a panel alone.

  • Outbreak signal

    Clusters of GI or respiratory positives trigger infection-control and public-health escalation.

  • Multi-drug-resistant organism

    mecA, KPC or NDM markers require isolation and antimicrobial-stewardship review.

  • TB — not detected by BioFire

    BioFire does not include Mycobacterium tuberculosis — request GeneXpert or culture if suspected.

  • Post-transplant infection

    Solid-organ or bone-marrow transplant recipients need the transplant team involved from the outset.

  • Suspected bioterror agent

    Any suspicion of anthrax, plague or similar is a national public-health emergency — escalate immediately.

Frequently asked

Everything patients and clinicians ask about BioFire.

Straight answers on what BioFire tests, how it compares to culture, and where its limits are.

  • What is BioFire testing?

    BioFire is a nested multiplex PCR platform that tests a single clinical sample against dozens of pathogens simultaneously, returning a result in about one hour. Panels are available for gastrointestinal, respiratory, meningitis / encephalitis and bloodstream infection.

  • How is BioFire different from conventional culture?

    Culture grows organisms over 24–72 hours and gives antimicrobial sensitivities; BioFire detects pathogen DNA or RNA in about an hour but does not give a full sensitivity profile. In practice both are run in parallel — BioFire drives the early treatment decision, culture confirms and refines it.

  • Which pathogens does BioFire detect?

    It depends on the panel. The GI panel covers Salmonella, Shigella, Campylobacter, C. difficile, Norovirus and more. The respiratory panel covers Influenza, RSV, SARS-CoV-2, adenovirus and Mycoplasma. The meningitis panel covers S. pneumoniae, N. meningitidis, HSV, VZV and enteroviruses. The blood-culture ID panel covers common Gram-positives, Gram-negatives and Candida.

  • Does BioFire test antibiotic sensitivity?

    Only in a limited way — the panels include resistance markers such as mecA, KPC, NDM and vanA/B. A full antimicrobial-sensitivity profile still requires conventional culture.

  • Does BioFire detect tuberculosis?

    No. Mycobacterium tuberculosis is not on any BioFire panel. If TB is suspected, a specific TB test (GeneXpert MTB/RIF, sputum smear, culture) is required.

  • How reliable is a negative BioFire result?

    The negative predictive value against the pathogens on the panel is very high — a negative result strongly argues against those organisms. It does not rule out pathogens not on the panel, so clinical interpretation still matters.

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In practice, in London

The London pathway for biofire testing

With biofire testing, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. The wait for biofire testing on the NHS depends heavily on where you live and how urgently the referral is graded. Central and West London private clinics can normally book within a week, with imaging or a procedure slot to follow shortly after. It’s worth being honest about the reason for going private: usually it’s time, not a fundamentally different test.

In practice, a private biofire testing appointment in London means a named consultant, a proper hour in the room (or the equivalent on a video call), and a report you can actually read. Most of the imaging suites and endoscopy units we use sit within a mile of Harley Street or in Chelsea and Fulham, and turnaround on findings is measured in days, not weeks. For biofire testing specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.

Fit matters more than people expect. For biofire testing, the right consultant depends on what you actually need — a second opinion, a definitive diagnosis, a bridge into treatment, or reassurance that nothing’s being missed. We match on that, not on who has the biggest brochure. If a test isn’t the right next step, we’ll say so before you book anything.

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