Wong Charles, Tong Chun Wai, Cheng Hei Shun, Chiu Pui Hing, Miu Flora Pui Ling, Lam Yiu Wing, Yam Loretta Yin Chun
Department of Medicine, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong, China.
Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
Ther Adv Respir Dis. 2025 Jan-Dec;19:17534666251341751. doi: 10.1177/17534666251341751. Epub 2025 Jun 21.
Acute exacerbations of bronchiectasis (AEB) are frequently caused by bacterial and/or viral infections. Rapid multiplex polymerase chain reaction (PCR) panels in respiratory specimens have significantly advanced microbial evaluation in patients with pneumonia. However, their clinical utility in patients with AEB remains unknown.
To investigate the microbial characteristics of AEB using FilmArray Pneumonia plus Panel (FAPP) and explore its clinical impact in a real-world setting.
A cross-sectional study.
Spontaneous sputum samples of patients hospitalized for AEB were tested using FAPP in addition to standard-of-care testing. Microbial characteristics of AEB and the clinical impact of FAPP were evaluated.
Among 83 patients, FAPP detected ⩾1 bacterial pathogen(s) in 68 samples (81.9%), identifying 101 bacteria, with high abundance (10 to ⩾10 copies/ml) observed in 48 patients (57.8%). The most commonly detected bacteria were () (37/83, 44.6%), (21/83, 25.3%), and (13/83, 15.7%). Respiratory viruses were identified in 21 patients (25.3), with and being the most common. Culture detected bacteria in significantly fewer samples ( = 25 [30.1%], < 0.001). FAPP demonstrated 100% positive percent agreement and negative predictive value for all cultured bacteria, except for ( = 2), which was not included in the panel. FAPP shortened the time to bacterial results (mean: 10.8 h vs 70.8 h by culture, < 0.001), and led to antimicrobial changes in 25 patients (30.1%) before the culture results were available. In multivariate analysis, chronic infection (odds ratio (OR) 14.71), underweight status (OR 5.84), and cystic bronchiectasis (OR 5.26) were independent predictors of detection by FAPP.
The sputum multiplex PCR panel (FAPP) enables rapid identification of bacterial and viral pathogens in AEB, supporting early antimicrobial decision-making. Our findings highlight the potential utility of sputum multiplex PCR panels in improving the management of bronchiectasis exacerbations.
支气管扩张急性加重（AEB）常由细菌和/或病毒感染引起。呼吸道标本中的快速多重聚合酶链反应（PCR）检测板显著推进了肺炎患者的微生物评估。然而，其在AEB患者中的临床应用仍不清楚。
使用FilmArray肺炎加检测板（FAPP）研究AEB的微生物特征，并在实际临床环境中探索其临床影响。
一项横断面研究。
除了标准治疗检测外，还使用FAPP对因AEB住院的患者的自发痰液样本进行检测。评估AEB的微生物特征和FAPP的临床影响。
在83例患者中，FAPP在68份样本（81.9%）中检测到≥1种细菌病原体，共鉴定出101种细菌，48例患者（57.8%）中观察到高丰度（10至≥10⁶拷贝/ml）。最常检测到的细菌是（）（37/83，44.6%）、（21/83，25.3%）和（13/83，15.7%）。21例患者（25.3%）中鉴定出呼吸道病毒，其中和最为常见。培养法检测到细菌的样本显著较少（=25[30.1%]，<0.001）。FAPP对所有培养出的细菌显示出100%的阳性百分比一致性和阴性预测值，但不包括检测板中未包含的（=2）。FAPP缩短了获得细菌检测结果的时间（平均：10.8小时对比培养法的70.8小时，<0.001），并在培养结果出来之前导致25例患者（30.1%）的抗菌治疗发生改变。在多变量分析中，慢性感染（比值比[OR]14.71）、体重过轻状态（OR 5.84）和囊性支气管扩张（OR 5.26）是FAPP检测到的独立预测因素。
痰液多重PCR检测板（FAPP）能够快速鉴定AEB中的细菌和病毒病原体，支持早期抗菌决策。我们的研究结果突出了痰液多重PCR检测板在改善支气管扩张急性加重管理方面的潜在效用。
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