采用 FilmArray Pneumonia Panel Plus 快速鉴定重症监护病房住院患者呼吸道样本中的细菌。
Rapid identification of bacteria from respiratory samples of patients hospitalized in intensive care units, with FilmArray Pneumonia Panel Plus.
机构信息
Department of Bacteriology, Saint-Louis-Lariboisière Hospital Group, Assistance Publique-Hôpitaux de Paris, Paris, France; University of Paris, INSERM 1137, IAME, Paris, France.
Department of Anaesthesiology and Critical Care and Burns Unit, Saint-Louis-Lariboisière Hospital Group, Assistance Publique - Hôpitaux de Paris, Paris, France; University of Paris, FHU PROMICE, INSERM 942, INI-CRCT Network, Paris, France.
出版信息
Int J Infect Dis. 2021 Jul;108:568-573. doi: 10.1016/j.ijid.2021.05.074. Epub 2021 Jun 1.
OBJECTIVES
This study aimed to evaluate the performance of FilmArray Pneumonia Panel Plus (FA-PP) for the detection of typical bacterial pathogens in respiratory samples from patients hospitalized in intensive care units (ICUs).
METHODS
FA-PP was implemented for clinical use in the microbiology laboratory in March 2020. A retrospective analysis on a consecutive cohort of adult patients hospitalized in ICUs between March 2020 and May 2020 was undertaken. The respiratory samples included sputum, blind bronchoalveolar lavage (BBAL) and protected specimen brush (PSB). Conventional culture and FA-PP were performed in parallel.
RESULTS
In total, 147 samples from 92 patients were analysed; 88% had coronavirus disease 2019 (COVID-19). At least one pathogen was detected in 46% (68/147) of samples by FA-PP and 39% (57/147) of samples by culture. The overall percentage agreement between FA-PP and culture results was 98% (93-100%). Bacteria with semi-quantitative FA-PP results ≥10 copies/mL for PSB samples, ≥10 copies/mL for BBAL samples and ≥10 copies/mL for sputum samples reached clinically significant thresholds for growth in 90%, 100% and 91% of cultures, respectively. FA-PP detected resistance markers, including mecA/C, bla and bla. The median turnaround time was significantly shorter for FA-PP than for culture.
CONCLUSIONS
FA-PP may constitute a faster approach to the diagnosis of bacterial pneumonia in patients hospitalized in ICUs.
目的
本研究旨在评估 FilmArray Pneumonia Panel Plus（FA-PP）在检测重症监护病房（ICU）住院患者呼吸道标本中典型细菌病原体方面的性能。
方法
FA-PP 于 2020 年 3 月在微生物实验室中投入临床使用。对 2020 年 3 月至 2020 年 5 月期间 ICU 住院的连续成人患者队列进行回顾性分析。呼吸道标本包括痰液、盲支气管肺泡灌洗（BBAL）和保护性标本刷（PSB）。同时进行常规培养和 FA-PP。
结果
共分析了 92 例患者的 147 份样本；88%的患者患有 2019 年冠状病毒病（COVID-19）。FA-PP 检测到 46%（68/147）的样本中至少有一种病原体，培养检测到 39%（57/147）的样本中至少有一种病原体。FA-PP 和培养结果的总体百分比一致性为 98%（93-100%）。PSB 样本 FA-PP 半定量结果≥10 拷贝/mL、BBAL 样本 FA-PP 半定量结果≥10 拷贝/mL 和痰样本 FA-PP 半定量结果≥10 拷贝/mL 的细菌在培养中分别达到生长的临床显著阈值 90%、100%和 91%。FA-PP 检测到包括 mecA/C、bla 和 bla 在内的耐药标记物。FA-PP 的中位周转时间明显短于培养。
结论
FA-PP 可能是 ICU 住院患者细菌性肺炎快速诊断的一种方法。
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