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

Abstract

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

Multinational evaluation of the BioFire® FilmArray® Pneumonia plus Panel as compared to standard of care testing

“…Lee et al demonstrated a PPA of 90% and NPA of 97.4% as compared to SOC bacteria detection, with BioFire PN Panel identifying a pathogen in 47.4% of BLS and in 60% of SLS for an overall positivity rate of 55.93% [24]. Edin demonstrated for on-panel pathogens a PPA of 100% and an NPA of 73.2% [25], and Gastli demonstrated a PPA of 94.4% and an NPA of 96.0% as compared to culture [26]. Similarly, a VAP study using a research use only version of BioFire PNplus Panel demonstrated for bacteria an 89.0% PPA and 95.9% NPA with SOC [27].…”

Streptococcal toxic shock syndrome in a patient with community-acquired pneumonia. Impact of rapid diagnostics on patient management

“…In our case, testing patient material by BioFire FilmArray Pneumonia Panel made definitive diagnosis possible 12 h before blood cultures were reported as positive and thereby made it possible to add clindamycin and IVGI earlier than conventional culture could support, which given the high mortality, especially within the first 24 h, potentially could have affected the patient outcome. Multiplex (syndromic) PCR is a promising tool for rapid analysis of tracheal sputum in patients presenting with severe pneumonia [10][11][12][13]. Different test panels exist on the market, each made with specific combinations of viruses, bacteria and genotypic markers of resistance [10].…”

“…Different test panels exist on the market, each made with specific combinations of viruses, bacteria and genotypic markers of resistance [10]. In general it is accepted that the method detects more pathogens than conventional culture [10][11][12][13], but no studies have so far translated this into improved clinical outcome or better usage of antibiotics [10]. The higher sensitivity may result in difficulties interpreting the result, one study found more samples positive for Staphylococcus aureus and Haemophilus influenzae compared to culture, where the found pathogen might have been a colonizer of the respiratory tract [12].…”

Nosocomial Pneumonia in the Era of Multidrug-Resistance: Updates in Diagnosis and Management

“…Similarly, a single-centre, prospective study by Edin et al evaluating the BPP plus compared to standard diagnostic culture-based techniques among 84 clinical samples (sputum, ETA and BAL) taken from both ICU and non-ICU patients with suspected lower respiratory tract infection, found that BPP plus detected a pathogen (including H. influenzae , S. aureus , Serratia marcescens , Mycoplasma pneumoniae , and P. aeruginosa ) that was not covered by the administered empirical antibiotics in 15 patients (25%) [ 68 ]. Moreover, the BPP plus demonstrated increased detection of viruses and atypical bacterial pathogens [ 68 ]. The overall PPA and NPA for BPP plus were 86% and 67.7%, respectively [ 68 ].…”

“…Moreover, the BPP plus demonstrated increased detection of viruses and atypical bacterial pathogens [ 68 ]. The overall PPA and NPA for BPP plus were 86% and 67.7%, respectively [ 68 ]. Although this observational study limits the evaluation of the panel’s efficacy in diagnostics and management, it was estimated that clinical decisions relating to isolation measures could potentially be influenced in 30% of patients [ 68 ].…”