Webber Daniel M, Wallace Meghan A, Burnham C A, Anderson Neil W
Division of Laboratory and Genomic Medicine, Department of Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.
Division of Laboratory and Genomic Medicine, Department of Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
J Clin Microbiol. 2020 Jun 24;58(7). doi: 10.1128/JCM.00343-20.
Our objective was to evaluate the diagnostic yield and accuracy of the BioFire FilmArray pneumonia panel (BFPP) for identification of pathogens in lower respiratory tract specimens ( = 200) from emergency department (ED) and intensive care unit (ICU) patients at a tertiary care academic medical center. Specimens were collected between January and November 2018, from patients ≥18 years of age, and culture was performed as part of standard-of-care testing. The BFPP identified a viral or bacterial target in 117/200 (58.5%) samples, including in 22% of samples and in 14%, and both a viral and bacterial target in 4% of samples. The most common viruses detected by BFPP were rhinovirus/enterovirus (4.5%), influenza A virus (3%), and respiratory syncytial virus (RSV) (2%). Overall, there was strong correlation between BFPP and standard methods for detection of viruses (99.2%) and bacteria (96.8%). Most bacteria (60/61 [98.4%]) detected by standard methods were also identified by BFPP, and 92 additional bacteria were identified by BFPP alone, including 22/92 (23.9%) additional isolates and 25/92 (27.2%) isolates, which were more frequently discordant when detected at low concentrations (, < 0.001; , < 0.0001) and in sputum-type specimens (, < 0.05). A potential limitation of the BFPP assay is the absence of fungal targets and , which were detected in 26 and 4 of 200 specimens, respectively. Real-time specimen analysis with BFPP has the potential to identify bacterial pathogens and resistance markers 44.2 and 56.3 h faster than culture-based methods. The BFPP is a rapid and accurate method for detection of pathogens from lower respiratory tract infections.
我们的目标是评估BioFire FilmArray肺炎检测板(BFPP)在一家三级医疗学术中心对急诊科(ED)和重症监护病房(ICU)患者下呼吸道标本(n = 200)中病原体的诊断率和准确性。标本于2018年1月至11月收集,来自年龄≥18岁的患者,并作为标准护理检测的一部分进行培养。BFPP在117/200(58.5%)的样本中鉴定出病毒或细菌靶点,其中病毒靶点占22%,细菌靶点占14%,4%的样本中同时存在病毒和细菌靶点。BFPP检测到的最常见病毒是鼻病毒/肠道病毒(4.5%)、甲型流感病毒(3%)和呼吸道合胞病毒(RSV)(2%)。总体而言,BFPP与病毒(99.2%)和细菌(96.8%)检测的标准方法之间存在很强的相关性。标准方法检测到的大多数细菌(60/61 [98.4%])也被BFPP鉴定出来,另外BFPP单独鉴定出92种细菌,包括22/92(23.9%)额外的葡萄球菌分离株和25/92(27.2%)肠球菌分离株,当在低浓度(P < 0.001;P < 0.0001)和痰型标本中检测到时,它们的差异更频繁(P < 0.05)。BFPP检测方法的一个潜在局限性是缺乏真菌靶点和分枝杆菌,在200份标本中分别有26份和4份检测到真菌和分枝杆菌。使用BFPP进行实时标本分析有可能比基于培养的方法快44.2和56.3小时鉴定出细菌病原体和耐药标志物。BFPP是一种快速、准确检测下呼吸道感染病原体的方法。