Quirino Angela, Cicino Claudia, Marascio Nadia, Barreca Giorgio Settimo, Gallo Luigia, Brescia Brunella, Trimboli Francesca, Pantanella Marta, Serapide Francesca, Russo Alessandro, Matera Giovanni, Trecarichi Enrico Maria
Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, "Mater Domini" Teaching Hospital, 88100, Catanzaro, Italy.
Department of Clinical and Experimental Medicine, University Magna Graecia, 88100, Catanzaro, Italy.
J Infect Chemother. 2025 Aug;31(8):102754. doi: 10.1016/j.jiac.2025.102754. Epub 2025 Jun 11.
Lower respiratory tract infections are reported as one of top five causes of mortality and morbidity in the world. A bacterial etiology is often involved in HAP, most frequently from multidrug resistant gram-negative bacteria, and fast accurate diagnosis of etiologic agent(s) of LRTI is essential for an appropriate management. The aim of this retrospective study was to evaluate the analytical performance of Biofire Filmarray Pneumonia Plus for bacteria detection in bronchoalveolar lavage samples and the concordance of bacterial loads between BFPP and cultural gold standard methods.
A total of 111 BAL samples were obtained from 111 consecutive patients admitted to Intensive Care Unit of "Renato Dulbecco" Teaching Hospital of Catanzaro, from March 2023 to March 2024.
Compared to conventional methods, BFPP showed a sensitivity of 99 % and a specificity of 64 %. The agreement between the two methods was assessed by calculating PPA and NPA, being 89 % and 95 %, respectively. The most common bacterial species identified at BFPP was Klebsiella pneumoniae, followed by Acinetobacter calcaceuticus-baumanii complex, Staphylococcus aureus and Pseudomonas aeruginosa. Bacterial load (CFU/ml) in relation to copy number detected by molecular analysis showed the best performance for value ≥10 copie/mL. About molecular mechanisms of resistance in comparison to phenotypic profiles, the highest level of performance was observed for presence of KPC genes, all isolates showing resistance to carbapenems, followed by OXA-48 like and NDM.
The high concordance reported in this study between the identification of resistance genes and phenotypic indication can lead to an appropriate, fast and tailored antibiotic therapy.
下呼吸道感染被报告为全球死亡率和发病率最高的五大原因之一。医院获得性肺炎（HAP）通常涉及细菌病因，最常见的是多重耐药革兰氏阴性菌，快速准确诊断下呼吸道感染（LRTI）的病原体对于适当治疗至关重要。这项回顾性研究的目的是评估Biofire Filmarray Pneumonia Plus在支气管肺泡灌洗样本中检测细菌的分析性能，以及BFPP与培养金标准方法之间细菌载量的一致性。
2023年3月至2024年3月期间，从卡坦扎罗“雷纳托·杜尔贝科”教学医院重症监护病房连续收治的111例患者中获取了111份支气管肺泡灌洗（BAL）样本。
与传统方法相比，BFPP的灵敏度为99%，特异性为64%。通过计算阳性预测值（PPA）和阴性预测值（NPA）评估两种方法之间的一致性，分别为89%和95%。BFPP鉴定出的最常见细菌种类是肺炎克雷伯菌，其次是钙不动杆菌-鲍曼不动杆菌复合体、金黄色葡萄球菌和铜绿假单胞菌。分子分析检测到的拷贝数与细菌载量（CFU/ml）在值≥10拷贝/mL时表现最佳。关于与表型特征相比的耐药分子机制，观察到KPC基因存在时的性能水平最高，所有分离株均对碳青霉烯类耐药，其次是OXA-48样和NDM。
本研究报告的耐药基因鉴定与表型指示之间的高度一致性可导致适当、快速和量身定制的抗生素治疗。
