Application of BioFire FilmArray Blood Culture Identification panel for rapid identification of the causative agents of ventilator-associated pneumonia

Pulido, Marta; Moreno-Martínez, Patricia; González-Galán, Verónica; Cuenca, Felipe Fernández; Pascual, A; Garnacho-Montero, José; Antonelli, Massimo; Dimοpoulos, George; Lepe, José Antonio; McConnell, Michael J.; Cisneros, José Miguel; Gallmore, P. Ramírez; Bonastre, Juan; García-Arriaza, Juan; Díaz-Miguel, R. Ortiz; García, Á Estella; Zaragoza, Rafael; Camerino, R Sierra; Gutiérrez, Manuel Herrera; Álvarez–Rocha, Luis; García, Miguel Sánchez; Gallego, Julio; Castellanos-Ortega, Álvaro; Prados, M.; Ferrer, Ricard; Vidal, Pablo; Armaganidis, Apostolos; Serafim,; Georgopoulos, Dimitrios; Pneumatikos, L.; Νάκος, Γεώργιος; Baltopoulos, George; Koutsoukou, Antonia; Zakynthinos, Epaminondas; Militsa-Bitsani,; Komnos, Apostolos; Pennisi, Maddalena; Pascale, Gennaro De; Gravio, Valentina Di; Rocco, Monica; Blasi, RA De; Gasperi, Andrea De; Rosa, V.M. Ranieri Francesco de; Robertis, Edoardo De; Guarracino,

doi:10.1016/j.cmi.2018.06.001

Cited by 30 publications

(15 citation statements)

References 15 publications

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“…Microbiological investigation of lower respiratory tract infection in patients in the critical care setting would benefit from new methodologies with increased sensitivity and turnaround time. The aetiology of pneumonia is broad and few commercial respiratory panel assays are available with a sufficiently wide range of targets, particularly for the Gram-positive and Gram-negative bacteria seen frequently in ventilator and hospital-associated pneumonia [3,4,[15][16][17]. In addition to this, rapid antibiotic resistance detection should enable more appropriate antibiotic selection to improve patient management, earlier antibiotic de-escalation to aid stewardship and earlier infection control interventions [18].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Unyvero P55 Pneumonia Cartridge, in-house PCR and culture for the identification of respiratory pathogens and antibiotic resistance in bronchoalveolar lavage fluids in the critical care setting

Gadsby

McHugh

Forbes

et al. 2019

Eur J Clin Microbiol Infect Dis

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Faster respiratory pathogen detection and antibiotic resistance identification are important in critical care due to the severity of illness, significant prior antibiotic exposure and infection control implications. Our objective was to compare the performance of the commercial Unyvero P55 Pneumonia Cartridge (Curetis AG) with routine bacterial culture methods and in-house bacterial multiplex real-time PCR assays. Seventy-four bronchoalveolar lavage specimens from patients admitted to a Scottish intensive care unit (ICU) over a 33-month period were tested prospectively by routine culture and viral PCR and retrospectively by Unyvero P55 and in-house bacterial PCR. Sensitivity/specificity was 56.9%/58.5% and 63.2%/54.8% for the Unyvero P55 and in-house bacterial PCR panels respectively; sensitivity for in-panel targets was 63.5 and 83.7% respectively. Additional organisms were detected by Unyvero P55 and in-house bacterial PCR panels in 16.2% specimens. Antibiotics were changed on the basis of routine test results in 48.3% cases; of these, true-positive or true-negative results would have been obtained earlier by Unyvero P55 or in-house bacterial PCR panel in 15 (53.6%) and 17 (60.7%) cases respectively. However, a false-negative molecular test result may have been acted upon in six (21.4%) cases with either assay. Sensitivity/specificity of Unyvero P55 antibiotic resistance detection was 18.8%/94.9% respectively. Molecular testing identified a number of respiratory pathogens in this patient cohort that were not grown in culture, but resistance detection was not a reliable tool for faster antibiotic modification. In their current setup , molecular tests may only have benefit as additional tests in the ICU pneumonia setting.

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Section: Discussionmentioning

confidence: 99%

Comparison of Unyvero P55 Pneumonia Cartridge, in-house PCR and culture for the identification of respiratory pathogens and antibiotic resistance in bronchoalveolar lavage fluids in the critical care setting

Gadsby

McHugh

Forbes

et al. 2019

Eur J Clin Microbiol Infect Dis

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“…Recent years' development in molecular diagnostic methods has led to a markedly increased availability of both commercial and in-house developed diagnostic panels targeting viruses and atypical bacterial pathogens [3]. However, examples of panels targeting typical respiratory bacteria are few [4][5][6], and molecular panels intended for LRTI diagnostics are even more scarce [7][8][9][10]. Methods combining targets for typical bacterial pathogens, atypical bacteria and viruses have so far been limited to qPCR-based panels, requiring a separate sample extraction step [8][9][10], which limit their use to larger clinical microbiology laboratories during working hours.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Biofire Filmarray Pneumonia panel plus for lower respiratory tract infections

Edin

Eilers

Allard

2020

Infectious Diseases

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Background: Standard diagnostic methods for lower respiratory tract infections are currently too slow and insensitive to guide early clinical decisions concerning treatment and isolation. Syndrome-specific, diagnostic panels have potential to provide information about aetiology quickly. Available panels have been of limited use in lower respiratory tract infections due to slow turn-around-time, lack of quantification of important pathogens and lack of detection of resistance genes.Materials/methods: We evaluated the newly developed Biofire V R Filmarray V R Pneumonia Panel plus (Biom erieux). Eightyeight consecutive lower respiratory tract samples were analyzed by both standard microbiological methods, as requested by the referring clinician, and by the panel. The agreement with standard methods, empirical treatment coverage and possible impact on isolation practices were assessed by comparing the results from standard diagnostic methods with the panel results in relation to clinical data and information of antimicrobial therapy.Results: Both qualitative and semi-quantitative results from the panel generally displayed good agreement with standard methods and by combining methods, a possible aetiology was detected in 73% of patients. Due to the panel approach, the panel detected viruses more frequently. In 25% of the 60 patients assessed for empirical treatment coverage, a pathogen not covered by current therapy was detected and in 30% of in-house patients the panel results were found to potentially influence clinical decisions related to isolation care. Conclusions:The new diagnostic panel shows promise in improving aetiological diagnostics of lower respiratory tract infections. Correctly applied it has potential to offer support in clinical decision-making within hours of sampling. KEYWORDSLower respiratory tract infections pneumonia rapid diagnostics molecular diagnostics PCR clinical impact ARTICLE HISTORY

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“…In general, blood cultures have shortcomings such as poor sensitivity with further limitations observed in the strength of the agglutination, which is not indicative of the pathogen causing the pneumonia and patients have to wait for days before getting a result. A blood culture may also produce false negative and false positive results as seen in patients with high titres of rheumatoid factors which may give false-positive results (Pulido et al 2018). However, chest X-ray test cannot tell what kind of germ is causing pneumonia (Rajpurkar et al 2017).…”

Section: Shortcomings and Benefits Of The Methods Of Pneumonia Diagnosismentioning

confidence: 99%

Diagnostic approaches of pneumonia for commercial-scale biomedical applications: an overview

et al. 2020

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Pneumonia remains the leading infectious cause of death among children under five years of age, and the elderly. Several biomarkers, which have been identified for its diagnosis lack specificity, as they could not differentiate viral from bacterial pathogens of the disease; these biomarkers also fail to establish a distinction between pneumonia and other associated diseases such as pulmonary tuberculosis and Human Immunodeficiency Virus (HIV). This review outlined the menace of pneumonia disease from the statistical prevalence, clinical and immunological view, challenges with the methods used in diagnosis, and more useful information about methods of diagnosis of pneumonia with their limitations as well. Additionally, the use of aptamers and antimicrobial peptides (AMPs) rather than antibodies to bind and recognize receptors for diagnostics, offers several advantages over other biomarkers shortcomings such as non-specificity.

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Application of BioFire FilmArray Blood Culture Identification panel for rapid identification of the causative agents of ventilator-associated pneumonia

Abstract: The BCID panel may have clinical utility in rapidly ruling out microorganisms causing VAP, specifically multidrug-resistant Gram-negative species. This could facilitate the optimization of empiric treatment.

Cited by 30 publications

References 15 publications

Comparison of Unyvero P55 Pneumonia Cartridge, in-house PCR and culture for the identification of respiratory pathogens and antibiotic resistance in bronchoalveolar lavage fluids in the critical care setting

Comparison of Unyvero P55 Pneumonia Cartridge, in-house PCR and culture for the identification of respiratory pathogens and antibiotic resistance in bronchoalveolar lavage fluids in the critical care setting

Evaluation of the Biofire Filmarray Pneumonia panel plus for lower respiratory tract infections

Diagnostic approaches of pneumonia for commercial-scale biomedical applications: an overview

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