El-Nawawy Ahmed A, Antonios Manal A, Tawfik Medhat E, Meheissen Marwa A
Department of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria 21512, Egypt.
Department of Medical Microbiology and Immunology, Faculty of Medicine, Alexandria University, Alexandria 21512, Egypt.
Antibiotics (Basel). 2022 Mar 27;11(4):453. doi: 10.3390/antibiotics11040453.
Rapid and accurate identification of healthcare associated pathogens is crucial for early diagnosis and treatment of infections. This study aimed to assess the performance of a point-of-care multiplex polymerase chain reaction (PCR) in diagnosis of pathogens and their antibiotic resistance genes in bloodstream infections, pneumonia and meningitis/encephalitis in a pediatric intensive care unit (PICU).
A retrospective cross-sectional study was conducted on pediatric patients diagnosed with healthcare associated infections at Alexandria University PICU, Egypt. A total of 111 samples from 98 patients were subjected simultaneously to standard-of-care microbiology testing (SOCMT) and molecular testing by BioFire multiplex PCR.
In comparison to SOCMT, the BioFire FilmArray had a better diagnostic yield with broncho-alveolar lavage (BAL) (45 vs. 21) and cerebrospinal fluid (CSF) samples (five vs. none) ( ≤ 0.0001). was the most common pathogen in BAL ( = 19 by BioFire, = 9 by SOCMT) and blood ( = 7, by SOCMT and BioFire) samples, while was the most common in CSF samples. BioFire showed 95.8% overall percent agreement, 100% positive percent agreement and 95.6% negative percent agreement with SOCMT. All phenotypically confirmed resistant isolates had resistance genes by the BioFire FilmArray (100%). The turnaround time (TAT) of positive results by the FilmArray panels was 1-1.5 h in comparison to 48-72 h by SOCMT ( ≤ 0.001).
The results of the current study confirm the utility of the BioFire FilmArray in making early decisions regarding patients' diagnosis and management of infection in the PICU, in terms of rapid TAT and appropriate antimicrobial use.
快速准确地鉴定医疗保健相关病原体对于感染的早期诊断和治疗至关重要。本研究旨在评估即时检验多重聚合酶链反应（PCR）在儿科重症监护病房（PICU）血流感染、肺炎和脑膜炎/脑炎病原体及其抗生素耐药基因诊断中的性能。
对埃及亚历山大大学PICU诊断为医疗保健相关感染的儿科患者进行回顾性横断面研究。来自98名患者的111份样本同时接受了标准护理微生物检测（SOCMT）和BioFire多重PCR分子检测。
与SOCMT相比，BioFire FilmArray在支气管肺泡灌洗（BAL）样本（45例对21例）和脑脊液（CSF）样本（5例对0例）中具有更高的诊断率（≤0.0001）。在BAL样本（BioFire检测出19例，SOCMT检测出9例）和血液样本（SOCMT和BioFire均检测出7例）中，[具体病原体名称未给出]是最常见的病原体，而在CSF样本中[具体病原体名称未给出]是最常见的。BioFire与SOCMT的总体一致性为95.8%，阳性一致性为100%，阴性一致性为95.6%。所有经表型确认的耐药菌株通过BioFire FilmArray检测均具有耐药基因（100%）。FilmArray检测板得出阳性结果的周转时间（TAT）为1 - 1.5小时，而SOCMT为48 - 72小时（≤0.001）。
本研究结果证实了BioFire FilmArray在PICU患者感染诊断和管理的早期决策方面的实用性，在快速周转时间和合理使用抗菌药物方面表现出色。
