Multicentric evaluation of BioFire FilmArray Pneumonia Panel for rapid bacteriological documentation of pneumonia

Gastli, Nabil; Loubinoux, Julien; Daragon, Matthieu; Lavigne, Jean‐Philippe; Saint-Sardos, Pierre; Pailhoriès, Hélène; Lemarié, Carole; Benmansour, Hanaa; d’Humières, Camille; Broutin, Lauranne; Dauwalder, Olivier; Levy, Michaël; Auger, Gabriel; Kernéis, Solen; Cattoir, Vincent; Alviset, Sophie; Armand-Lefèvre, Laurence; Baldeyrou, M.; Becker, Agathe; Boibieux, A.; Bonacorsi, Stéphane; Burucoa, Christophe; Cambau, Emmanuelle; Casalegno, Jean-Sébastien; Cointe, Aurélie; Cremniter, Julie; Destras, Grégory; Duquaire, Paul; Geslain, Guillaume; Gustave, Claude-Alexandre; Jacquier, Hervé; Kouatchet, Achille; Lecorché, Emmanuel; Lejeune, Manon; Lina, Bruno; Mahieu, Rafaël; Maamar, Adel; Michaud, Anthony L.; Monnard, Céline; Montravers, Philippe; Neuwirth, Catherine; Ponfilly, Gauthier Péan de; Pichon, Maxime; Plouzeau, Chloé; Poyart, Claire; Quenot, Jean‐Pierre; Rzepecki, Vincent; Stéphan, Robin; Timsit, Jean‐François; Tran-Dinh, Alexy; Vandenesch, F.; Vigier, Emmanuelle

doi:10.1016/j.cmi.2020.11.014

Cited by 56 publications

(53 citation statements)

References 23 publications

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“…In our study, the mPCR provided good overall performance for bacteria, with a PPV of 85.6% which is above what has been found in previous studies (between 46.9 and 79.6%) and an NPV of 99.5% which is consistent with previous studies [10][11][12][13]. Other studies showed positive and negative percentage agreement of mPCR compared to culture between 90 and 98.4% and 96 and 97% respectively [9,12,14].…”

Section: Discussionsupporting

confidence: 91%

“…However, bacterial panel is not exhaustive and can miss some species causing HAP or VAP such as M. morganii or S. maltophilia. We also observed that in some cases, bacteria were detected by culture and not by mPCR, which was already described previously, since the manufacturer threshold is 10 3.5 genomic copies/mL [12,15]. On the other hand, we observed that, when the bacteria were only detected by mPCR, the patients had received antibiotics active on these germs in the previous days, which could explain why they were not found in culture.…”

Section: Discussionsupporting

confidence: 78%

“…Our study is one of the first to analyze the impact of mPCR on the management of antibiotic therapy in COVID-19 patients suspected of bacterial pneumonia [16]. Only 33% of mPCR were positive, lower than in other studies, in which it ranged between 58.5 and 74.6%, confirming the difficulty of diagnosing bacterial superinfection in COVID-19 ICU patients [9,10,12,14].…”

Section: Discussionmentioning

confidence: 56%

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Impact of rapid multiplex PCR on management of antibiotic therapy in COVID-19-positive patients hospitalized in intensive care unit

Maataoui

Chemali

Patrier

et al. 2021

Eur J Clin Microbiol Infect Dis

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Because the diagnosis of co/superinfection in COVID-19 patients is challenging, empirical antibiotic therapy is frequently initiated until microbiological analysis results. We evaluated the performance and the impact of the BioFire® FilmArray® Pneumonia plus Panel on 112 respiratory samples from 67 COVID-19 ICU patients suspected of co/superinfections. Globally, the sensitivity and specificity of the test were 89.3% and 99.1%, respectively. Positive tests led to antibiotic initiation or adaptation in 15% of episodes and de-escalation in 4%. When negative, 28% of episodes remained antibiotic-free (14% no initiation, 14% withdrawal). Rapid multiplex PCRs can help to improve antibiotic stewardship by administering appropriate antibiotics earlier and avoiding unnecessary prescriptions. Supplementary Information The online version contains supplementary material available at 10.1007/s10096-021-04213-6.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 56%

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Impact of rapid multiplex PCR on management of antibiotic therapy in COVID-19-positive patients hospitalized in intensive care unit

Maataoui

Chemali

Patrier

et al. 2021

Eur J Clin Microbiol Infect Dis

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“…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].…”

Section: Number and Type Of Microorganisms Reported By Soc Notmentioning

confidence: 99%

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

Ginocchio

Garcia-Mondragon

Mauerhofer

et al. 2021

Eur J Clin Microbiol Infect Dis

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This study compared standard of care testing (SOC) to BioFire® FilmArray® Pneumonia plus Panel (PNplus). PNplus detects 15 bacteria with semiquantitative log bin values, 7 antibiotic resistance markers, three atypical bacteria (AB), and eight viral classes directly from bronchoalveolar lavage-like specimens (BLS) and sputum-like specimens (SLS). Fifty-two laboratories from 13 European countries and Israel tested 1234 BLS and 1242 SLS with PNplus and SOC. Detection rates and number of pathogens/samples were compared for PNplus pathogens. PNplus bin values and SOC quantities were compared. Three thousand two hundred sixty-two bacteria in PNplus were detected by PNplus and/or SOC. SOC detected 57.1% compared to 95.8% for PNplus (p ≤ 0.0001). PNplus semiquantitative bin values were less than SOC, equal to SOC, or greater than SOC in 5.1%, 25.4%, and 69.6% of results, respectively. PNplus bin values were on average ≥ 1 log than SOC values (58.5% 1–2 logs; 11.0% 3–4 logs). PNplus identified 98.2% of MRSA and SOC 55.6%. SOC detected 73/103 AB (70.9%) and 134/631 viruses (21.2%). PNplus detected 93/103 AB (90.3%) and 618/631 viruses (97.9%) (p ≤ 0.0001). PNplus and SOC mean number of pathogens/samples were 1.99 and 1.44, respectively. All gram-negative resistance markers were detected. PNplus and SOC results were fully or partially concordant for 49.1% and 26.4% of specimens, respectively. PNplus was highly sensitive and detected more potential pneumonia pathogens than SOC. Semiquantification may assist in understanding pathogen significance. As PNplus generates results in approximately 1 h, PNplus has potential to direct antimicrobial therapy in near real time and improve antimicrobial stewardship and patient outcomes.

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“…Molecular tests based on multiplex PCR have been developed to simultaneously detect and quantify multiple respiratory pathogens, as well as some genes related to antimicrobial resistance. Several commercial multiplex platforms are currently available for comprehensive molecular testing for respiratory pathogens that cause pneumonia (respiratory viruses, bacteria and fungi) and for the main resistance genes of the most common bacteria causing pneumonia [195][196][197][198] .…”

Section: Microbiology and Laboratory Testsmentioning

confidence: 99%

Pneumonia

Torres

Niederman

Menéndez

et al. 2021

Nat Rev Dis Primers

343

261

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Pneumonia is a common acute respiratory infection that affects the alveoli and distal bronchial tree of the lungs. The disease is broadly divided into community-acquired pneumonia (CAP) or hospital-acquired pneumonia (HAP, which includes ventilation-associated pneumonia (VAP)) (Box 1). Aspiration pneumonia represents 5-15% of all cases of CAP; however, its prevalence amongst patients with HAP is not known 1 . The lack of robust diagnostic criteria for aspiration pneumonia may explain why the true burden of this type of pneumonia remains unknown 1 .The causative microorganisms for CAP and HAP differ substantially. The most common causal microorganisms in CAP are Streptococcus pneumoniae, respiratory viruses, Haemophilus influenzae and other bacteria such as Mycoplasma pneumoniae and Legionella pneumophila. Conversely, the most frequent microorganisms in HAP are Staphylococcus aureus (including both methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA)), Enterobacterales, non-fermenting gram-negative bacilli (for example, Pseudomonas aeruginosa), and Acinetobacter spp. 2,3 . In health-care-associated pneumonia (HCAP), owing to patient risk factors, the microbial aetiology is more similar to that in HAP than to that in CAP. However, difficulties in standardizing risk factors for this population, coupled with the heterogeneity of post-hospital health care worldwide, suggest that the concept of HCAP has little usefulness, and indeed, HCAP was not included in recent guidelines for CAP and HAP [3][4][5] .Differences in microbiology between CAP and HAP depend on whether pneumonia was acquired in the community or health care environment and on host risk factors, including abnormal gastric and oropharyngeal colonization. In addition, the aetiopathogenesis of CAP is different from that of HAP. In general, mild CAP is treated on an outpatient basis, moderately severe CAP in hospital wards, and severe CAP in intensive care units (ICUs) with or without mechanical ventilation 6 . The need for mechanical ventilation is used as a sub-classification of interest for prognosis and stratification in randomized clinical trials.Both CAP 7 and HAP 4 can occur in either immunosuppressed or immunocompetent patients. To date, most research data have been based on studies of immunocompetent patients and, therefore, we rely on such sources in this Primer. However, CAP, HAP and VAP in immunosuppressed patients have attracted the attention of researchers, and more investigation is to come.In this Primer, we cover and summarize the most important and recent updates related to epidemiology, pathophysiology, diagnostic screening, prevention, management, quality of life, and research perspectives. Additionally, owing to the profound impact of the coronavirus disease 2019 (COVID-19) pandemic caused by

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Multicentric evaluation of BioFire FilmArray Pneumonia Panel for rapid bacteriological documentation of pneumonia

Cited by 56 publications

References 23 publications

Impact of rapid multiplex PCR on management of antibiotic therapy in COVID-19-positive patients hospitalized in intensive care unit

Impact of rapid multiplex PCR on management of antibiotic therapy in COVID-19-positive patients hospitalized in intensive care unit

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

Pneumonia

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