Dataset Information

Evaluation of the clinical relevance of the Biofire^© FilmArray pneumonia panel among hospitalized patients.

ABSTRACT:

Purpose

Panel PCR tests provide rapid pathogen identification. However, their diagnostic performance is unclear. We assessed the performance of the Biofire^© FilmArray pneumonia (PN)-panel against standard culture in broncho-alveolar lavage (BAL) samples.

Methods

Setting: University Hospital Basel (February 2019 to July 2020), including hospitalized patients with a BAL (± pneumonia). We determined sensitivity and specificity of the PN-panel against standard culture. Using univariate logistic regression, we calculated odds ratios (OR) for pneumonia according to PN-panel and culture status, stratifying by chronic pulmonary disease. We calculated ORs for pneumonia for different pathogens to estimate the clinical relevance.

Results

We included 840 adult patients, 60% were males, median age was 68 years, 35% had chronic pulmonary disease, 21% had pneumonia, and 36% had recent antibiotic use. In 1078 BAL samples, bacterial pathogens were detected in 36% and 16% with PN-panel and culture, respectively. The overall sensitivity and specificity of the PN-panel was high, whereas the positive predictive value was low. The OR of pneumonia was 1.1 (95% CI 0.7-1.6) for PN-panel-positive only; 2.6 (95% CI 1.3-5.3) for culture-positive only, and 1.6 (95% CI 1.0-2.4) for PN-panel and culture-positive. The detection rate of Haemophilus influenzae, Staphylococcus aureus, and Moraxella catarrhalis in the PN-panel was high but not associated with pneumonia.

Conclusion

While sensitivity and specificity of PN-panel are high compared to culture, pathogen detection did not correlate well with a pneumonia diagnosis. Patients with culture-positive BAL had the highest OR for pneumonia-thus the impact of the PN-panel on clinical management needs further evaluation in randomized controlled trials.

SUBMITTER: Sogaard KK

PROVIDER: S-EPMC10810975 | biostudies-literature | 2024 Feb

REPOSITORIES: biostudies-literature

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Publications

Søgaard Kirstine K KK Hinic Vladimira V Goldenberger Daniel D Gensch Alexander A Schweitzer Michael M Bättig Veronika V Siegemund Martin M Bassetti Stefano S Bingisser Roland R Tamm Michael M Battegay Manuel M Weisser Maja M Stolz Daiana D Khanna Nina N Egli Adrian A

Infection 20230812 1

<h4>Purpose</h4>Panel PCR tests provide rapid pathogen identification. However, their diagnostic performance is unclear. We assessed the performance of the Biofire<sup>©</sup> FilmArray pneumonia (PN)-panel against standard culture in broncho-alveolar lavage (BAL) samples.<h4>Methods</h4>Setting: University Hospital Basel (February 2019 to July 2020), including hospitalized patients with a BAL (± pneumonia). We determined sensitivity and specificity of the PN-panel against standard culture. Usin ...[more]

PMID: 37572241

Similar Datasets

Project description:BackgroundExisting panels for lower respiratory tract infections (LRTIs) are slow and lack quantification of important pathogens and antimicrobial resistance, which are not solely responsible for their complex etiology and antibiotic resistance. BioFire FilmArray Pneumonia (PN) panels may provide rapid information on their etiology.MethodsThe bronchoalveolar lavage fluid of 187 patients with LRTIs was simultaneously analyzed using a PN panel and cultivation, and the impact of the PN panel on clinical practice was assessed. The primary endpoint was to compare the consistency between the PN panel and conventional microbiology in terms of etiology and drug resistance, as well as to explore the clinical significance of the PN panel. The secondary endpoint was pathogen detection using the PN panel in patients with community-acquired pneumonia (CAP) or hospital-acquired pneumonia (HAP).ResultsFifty-seven patients with HAP and 130 with CAP were included. The most common pathogens of HAP were Acinetobacter baumannii and Klebsiella pneumoniae, with the most prevalent antimicrobial resistance (AMR) genes being CTX-M and KPC. For CAP, the most common pathogens were Haemophilus influenzae and Staphylococcus aureus, with the most frequent AMR genes being CTX-M and VIM. Compared with routine bacterial culture, the PN panel demonstrated an 85% combined positive percent agreement (PPA) and 92% negative percent agreement (NPA) for the qualitative identification of 13 bacterial targets. PN detection of bacteria with higher levels of semi-quantitative bacteria was associated with more positive bacterial cultures. Positive concordance between phenotypic resistance and the presence of corresponding AMR determinants was 85%, with 90% positive agreement between CTX-M-type extended-spectrum beta-lactamase gene type and phenotype and 100% agreement for mecA/C and MREJ. The clinical benefit of the PN panel increased by 25.97% compared with traditional cultural tests.ConclusionThe bacterial pathogens and AMR identified by the PN panel were in good agreement with conventional cultivation, and the clinical benefit of the PN panel increased by 25.97% compared with traditional detection. Therefore, the PN panel is recommended for patients with CAP or HAP who require prompt pathogen diagnosis and resistance identification.

Dataset Information

Evaluation of the clinical relevance of the Biofire^© FilmArray pneumonia panel among hospitalized patients.

Purpose

Methods

Results

Conclusion

Publications

Evaluation of the clinical relevance of the Biofire<sup>©</sup> FilmArray pneumonia panel among hospitalized patients.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

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Dataset Information

Evaluation of the clinical relevance of the Biofire© FilmArray pneumonia panel among hospitalized patients.

Purpose

Methods

Results

Conclusion

Publications

Evaluation of the clinical relevance of the Biofire<sup>©</sup> FilmArray pneumonia panel among hospitalized patients.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Evaluation of the clinical relevance of the Biofire^© FilmArray pneumonia panel among hospitalized patients.