Evaluation PCR panel of the FilmArray® pneumonia plus for pathogen detection of ventilator-associated pneumonia in children and its impact on therapeutic management

Debbagh, Fayrouz; Houmich, Toufik Ben; Guennouni, Morad; Sahraoui, Houssameddine; Hanchi, Asma Lamrani; Mouaffak, Y.; Younous, S.; Soraa, Nabila

doi:10.18502/ijm.v15i1.11914

Cited by 3 publications

(10 citation statements)

References 14 publications

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“…Out of the 33 patients diagnosed with VAP, more than half (65.9%) had multiple pathogens detected; K. pneumonia P. aeruginosa, and Acinetobacter calcoaceticus-baumannii complex were the most frequently isolated pathogens. There is only one prospective observational study about the evaluation of the FA-PP in children with VAP in the PICU [17].…”

Section: Discussionmentioning

confidence: 99%

“…The results revealed a PPA of 97%, with a negative NPA agreement of 95% compared to normal antibiotic sensitivity testing. Debbagh et al [17] demonstrated that the identification of resistance genes revealed a significant prevalence of carbapenemases (65.2%) and ESBLs (34.8%) using the FA-PP in a pediatric setting. This observation can be attributed to the administration of previous, frequently broad-spectrum, antibiotic treatment among critically ill patients admitted to the intensive care unit.…”

Section: Discussionmentioning

confidence: 99%

“…The utilization of the FA-PP facilitates the differentiation between the commensal and pathogenic states of bacteria by enabling the identification of these microorganisms at semi-quantitative thresholds. According to Debbagh et al [17], there is a positive correlation between the threshold level and the likelihood of a bacterium being associated with a lower respiratory tract infection. Sandulescu et al [22] proposed the implementation of a diagnostic and antimicrobial stewardship approach specifically targeting patient populations deemed to be at a heightened risk of acquiring multidrug-resistant bacterial infections.…”

Section: Discussionmentioning

confidence: 99%

“…There is a total of 15 distinct bacteria (semiquantitative data provided), 3 atypical bacteria, 9 viruses, and 7 distinct antibiotic-resistance genes [9,10]. Although there is evidence of the efficacy of the FA-PP in the adult setting for rapidly diagnosing the complicated microbiological etiologies of pneumonia infections, there are limited data in the PICU situation [3,[9][10][11][12][13][14][15][16][17]. The purpose of this research was to evaluate the performance of a rapid molecular diagnostic pneumonia panel, the FA-PP, for use with children in the PICU who have lower respiratory tract infections.…”

Section: Introductionmentioning

confidence: 99%

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Supporting Clinical Decisions with Rapid Molecular Diagnostic Pneumonia Panel in Pediatric Intensive Care Unit: Single Center Experience in Turkiye

Bozan,

Kara,

Kiral

et al. 2023

Microorganisms

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Introduction: Lower respiratory tract infections are the leading cause of morbidity and mortality in children worldwide. It is crucial to promptly conduct diagnostic investigations in order to determine the microbiological cause of pneumonia, since this is necessary to ensure the appropriate delivery of antibiotic therapy to each individual patient. We evaluated the results of a rapid molecular diagnostic pneumonia panel in children with LRTI in a pediatric intensive care unit (PICU). Patients and Methods: Rapid molecular diagnostic pneumonia panel (BioFire®, FilmArray Pneumonia Panel plus; FA-PP) findings (71 results from 46 children) in a tertiary care PICU between 2019 and 2023 were retrospectively reviewed. Results: At least one bacterial pathogen was detected in 57 cases. A total of 77% of children had underlying conditions. A total of 70.4% of children needed invasive mechanical ventilation and 54.4% had ventilator-associated pneumonia. Pseudomonas aeruginosa (50.8%), Acinetobacter calcoaceticus baumannii complex (42%), and Klebsiella pneumoniae (38.6%) were the most common pathogens detected with the FA-PP. Of the 33 cases diagnosed with VAP, more than one pathogen was identified in 65.9% of cases, with the most commonly identified bacteria being K. pneumoniae (43.1%), P. aeruginosa (38.6%), and Acinetobacter calcoaceticus baumannii complex (31.8%). According to the FA-PP results, the same antibiotic therapy was continued in 39.4% of cases, escalated in 54.5%, and de-escalated in 6.1%. Conclusions: The utilization of the FA-PP has some beneficial effects, including more prompt delivery of findings compared to conventional approaches. Additionally, this approach enables the identification of resistance profiles in children diagnosed with pneumonia in the PICU. Consequently, these test results facilitate the organization of antibiotic treatment strategies, including escalation and de-escalation approaches. The detection of resistance patterns was exclusively determined via the implementation of molecular testing, prompting a reevaluation of the isolation technique in accordance with the obtained data.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Supporting Clinical Decisions with Rapid Molecular Diagnostic Pneumonia Panel in Pediatric Intensive Care Unit: Single Center Experience in Turkiye

Bozan,

Kara,

Kiral

et al. 2023

Microorganisms

View full text Add to dashboard Cite

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“…An additional study confirms the greater incidence of viruses in NP among children. Debbagh and co-workers conducted a small, single-centre analysis of pediatric VAP, which explored viral etiologies in 38 children [ 20 ]. Extensive testing of bronchial secretions with mPCR demonstrated the presence of a virus in the lower airway in 30.7% of patients [ 20 ].…”

Section: Pediatric Viral Npmentioning

confidence: 99%

Respiratory Viruses in Nosocomial Pneumonia: An Evolving Paradigm

Zilberbeg¹,

Khan

Shorr

2023

Viruses

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Nosocomial pneumonia (NP) represents a leading cause of morbidity and mortality in hospitalized patients. Historically, clinicians have considered hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), which comprise NP, to be essentially bacterial processes. As such, patients suspected of having either HAP or VAP are initially treated with broad-spectrum antibiotics, and few clinicians search for a possible culprit virus. Recent reports which build on earlier studies, however, indicate that viruses likely play an important role in NP. Studies employing viral diagnostics as part of the evaluation for NP indicate that common respiratory viruses can spread nosocomially and lead to HAP and VAP. Similarly, studies of the general epidemiology of respiratory viral infections, such as influenza, respiratory syncytial virus, adenovirus, and rhinovirus, confirm that these pathogens are important causes of NP, especially among immunosuppressed and pediatric patients. More importantly, these more contemporary analyses reveal that one cannot, based on clinical characteristics, distinguish a viral from a bacterial cause of NP. Additionally, viral HAP and VAP result in crude mortality rates that rival or exceed those reported in bacterial NP. Rigorous prospective, multicenter trials are needed to confirm the significance of respiratory viruses in NP, as are studies of novel therapeutics for these viral infections.

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Impact of Nested Multiplex Polymerase Chain Reaction Assay in the management of pediatric patients with acute respiratory tract infections: a single center experience

2023

Infez Med

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Acute lower respiratory infection (ALRI) remains a global public health problem among children. Distinguishing the etiology of ALRI is challenging and rapid pathogen identification is critical for optimizing the diagnosis and treatment of infectious diseases. Multiplex polymerase chain reaction (PCR) is sensitive, simple, and rapid. Our objective was to evaluate the diagnostic yield and prognostic significance of the Fil-mArray test for identification of pathogens in pediatric patients with ALRI at a tertiary care center. Methods: A prospective observational cross-sectional study involved 230 pediatric patients presented with acute lower respiratory tract (LRT) symptoms, for whom conventional bacterial culture and FilmArray testing was ordered to aid in the proper diagnosis of the implicated respiratory pathogens.Results: FilmArray Respiratory panel (FARP) was positive in 201 patients (87.4%). The most common detected pathogens were Respiratory syncytial virus (RSV), Human Rhinovirus/Enterovirus, Parainfluenza, Influenza A, and Klebsiella pneumoniae; 45 (19.6%), 38 (16.5%), 11 (4.8%), 8 (3.5%) and 6 (2.6%) respectively. FilmArray enabled a change in antimicrobial therapy in 168 (73%) of the patients. Conclusions: FilmArray enables to improve etiological diagnosis of ALRI and optimize the antimicrobial use of drugs in critical care pediatric patients. Clinical correlation is essential to interpret multiple pathogens and resistance genes.

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Evaluation PCR panel of the FilmArray® pneumonia plus for pathogen detection of ventilator-associated pneumonia in children and its impact on therapeutic management

Cited by 3 publications

References 14 publications

Supporting Clinical Decisions with Rapid Molecular Diagnostic Pneumonia Panel in Pediatric Intensive Care Unit: Single Center Experience in Turkiye

Supporting Clinical Decisions with Rapid Molecular Diagnostic Pneumonia Panel in Pediatric Intensive Care Unit: Single Center Experience in Turkiye

Respiratory Viruses in Nosocomial Pneumonia: An Evolving Paradigm

Impact of Nested Multiplex Polymerase Chain Reaction Assay in the management of pediatric patients with acute respiratory tract infections: a single center experience

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