Emergency Care Clinic, Haukeland University Hospital, Bergen, Norway.
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Sci Rep. 2022 Jan 10;12(1):326. doi: 10.1038/s41598-021-03741-7.
Lack of rapid and comprehensive microbiological diagnosis in patients with community acquired pneumonia (CAP) hampers appropriate antimicrobial therapy. This study evaluates the real-world performance of the BioFire FilmArray Pneumonia panel plus (FAP plus) and explores the feasibility of evaluation in a randomised controlled trial. Patients presenting to hospital with suspected CAP were recruited in a prospective feasibility study. An induced sputum or an endotracheal aspirate was obtained from all participants. The FAP plus turnaround time (TAT) and microbiological yield were compared with standard diagnostic methods (SDs). 96/104 (92%) enrolled patients had a respiratory tract infection (RTI); 72 CAP and 24 other RTIs. Median TAT was shorter for the FAP plus, compared with in-house PCR (2.6 vs 24.1 h, p < 0.001) and sputum cultures (2.6 vs 57.5 h, p < 0.001). The total microbiological yield by the FAP plus was higher compared to SDs (91% (162/179) vs 55% (99/179), p < 0.0001). Haemophilus influenzae, Streptococcus pneumoniae and influenza A virus were the most frequent pathogens. In conclusion, molecular panel testing in adults with CAP was associated with a significant reduction in time to actionable results and increased microbiological yield. The impact on antibiotic use and patient outcome should be assessed in randomised controlled trials.
社区获得性肺炎（CAP）患者缺乏快速全面的微生物诊断，这阻碍了适当的抗菌治疗。本研究评估了生物火膜阵列肺炎检测试剂盒（FAP plus）在真实世界中的性能，并探索了在随机对照试验中进行评估的可行性。本前瞻性可行性研究招募了因疑似 CAP 而就诊于医院的患者。所有参与者均采集诱导痰或气管内抽吸物。比较 FAP plus 的检测周转时间（TAT）和微生物学检出率与标准诊断方法（SDs）。96/104（92%）入组患者患有下呼吸道感染（RTI）；72 例 CAP 和 24 例其他 RTI。与院内 PCR（2.6 小时比 24.1 小时，p<0.001）和痰培养（2.6 小时比 57.5 小时，p<0.001）相比，FAP plus 的中位 TAT 更短。与 SDs 相比，FAP plus 的总微生物学检出率更高（91%（162/179）比 55%（99/179），p<0.0001）。流感嗜血杆菌、肺炎链球菌和甲型流感病毒是最常见的病原体。总之，在 CAP 成人中进行分子检测试剂盒检测与获得可操作结果的时间显著缩短和微生物学检出率增加相关。应在随机对照试验中评估其对抗生素使用和患者结局的影响。
