Evaluation of the BioFire FilmArray Pneumonia Panel for Lower Respiratory Tract Specimens in Tertiary Care Medical Centre

Abstract

Lower respiratory tract infections are an important cause of morbidity and mortality. Identification of infectious etiology is very important for specific treatment. In addition to routine methods in diagnosis, polymerase chain reaction-based tests have been used. By identifying pathogenic organisms and specific antibiotic resistance markers earlier than routine methods, these tests have the potential to accurately detect agent and reduce the duration of antibiotic therapy. The aim of this study is to show that the use of multiplex polymerase chain reaction-based method may be useful in early diagnosis and specific treatment.

In this study, 283 lower respiratory tract samples sent to Ondokuz Mayıs University Faculty of Medicine Hospital Molecular Microbiology Laboratory between 01/08/2021–01/04/2023 were retrospectively analyzed. Lower respiratory tract samples were studied with BioFire^® FilmArray Pneumonia Panel plus (BioMérieux, France). The lower respiratory tract samples of the patients sent at the same time were planted on 5% sheep blood agar, chocolate and EMB agar and incubated at 36° for 24 h. Identification of bacteria was performed by Vitek MS. Antibiotic sensitivities were studied in Vitek2 Compact automated systems.

Two hundred and eighty-three patient samples were included in the study; 156 (55%) of the samples were bronchoalveolar lavage samples and 127 (45%) are sputum samples. When panel and culture results were compared, compatible results were found in 70%. In 88 (61%) of the patients with no growth in culture, no agent was detected as a result of the panel or only viral agents were detected. MecA/C and MREJ resistance genes were detected in 26% of 46 patients with S. aureus detected in the pneumonia panel. CTX-M resistance gene was detected in a total of 28 samples in the pneumonia panel. The OXA-48 carbapenem resistance gene was detected in 14 samples.

In our study, it has been shown that Multiplex-PCR has an important place in detecting atypical bacterial and viral factors that do not grow in routine culture in lower respiratory tract infections. In addition, by identifying the resistance genes in the detected bacterial agents, it will contribute to the correct initiation of empirical treatment and to prevent unnecessary antibiotic use in lower  espiratory tract diseases where viral factors play a role.