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Biofire® Filmarray® Pneumonia Plus 检测 panel 在 COVID-19 时代对机械通气患者下呼吸道感染的管理:一项诊断和成本效益评估。

The Biofire® Filmarray® Pneumonia Plus panel for management of lower respiratory tract infection in mechanically-ventilated patients in the COVID-19 era: a diagnostic and cost-benefit evaluation.

机构信息

Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain.

Medical Intensive Care Unit, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain.

出版信息

Diagn Microbiol Infect Dis. 2023 Feb;105(2):115847. doi: 10.1016/j.diagmicrobio.2022.115847. Epub 2022 Nov 2.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2636/9625846/e2d0d971c538/gr1_lrg.jpg

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