Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain.
Medical Intensive Care Unit, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain.
Diagn Microbiol Infect Dis. 2023 Feb;105(2):115847. doi: 10.1016/j.diagmicrobio.2022.115847. Epub 2022 Nov 2.
We assessed the diagnostic performance of the Biofire® Filmarray® Pneumonia Plus panel (FA-PP) compared to standard culture in Intensive Care Unit patients with suspected ventilator-associated lower respiratory tract infection in the COVID-19 era. We determined whether its implementation in routine diagnostic algorithms would be cost-beneficial from a hospital perspective. Of 163 specimens, 96 (59%) returned negative results with FA-PP and conventional culture, and 29 specimens (17.8%) were positive with both diagnostic methods and yielded concordant qualitative bacterial identification/isolation. Thirty-nine specimens (23.9%) gave discordant results (positive via FA-PP and negative via culture). Real-life adjustments of empirical antimicrobial therapy (EAT) after FA-PP results resulted in additional costs beyond EAT alone of 1868.7 €. Adequate EAT adjustments upon FA-PP results would have resulted in a saving of 6675.8 €. In conclusion, the data presented supports the potential utility of FA-PP for early EAT adjustment in patients with ventilator-associated lower respiratory tract infection.
我们评估了 Biofire® Filmarray® Pneumonia Plus 检测 panel(FA-PP)与标准培养方法在 COVID-19 时代 ICU 中疑似呼吸机相关性下呼吸道感染患者中的诊断性能。我们确定从医院角度来看,其在常规诊断算法中的应用是否具有成本效益。在 163 份标本中,96 份(59%)FA-PP 和常规培养均为阴性,29 份标本(17.8%)两种诊断方法均为阳性,且定性细菌鉴定/分离结果一致。39 份标本(23.9%)结果不一致(FA-PP 阳性,培养阴性)。FA-PP 结果后对经验性抗菌治疗(EAT)进行现实生活中的调整,除 EAT 外还增加了 1868.7 欧元的额外费用。根据 FA-PP 结果进行充分的 EAT 调整将节省 6675.8 欧元。总之,目前的数据支持 FA-PP 在呼吸机相关性下呼吸道感染患者中早期进行 EAT 调整的潜在应用价值。