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- Title
Evaluation of the clinical relevance of the Biofire<sup>©</sup> FilmArray pneumonia panel among hospitalized patients.
- Authors
Søgaard, Kirstine K.; Hinic, Vladimira; Goldenberger, Daniel; Gensch, Alexander; Schweitzer, Michael; Bättig, Veronika; Siegemund, Martin; Bassetti, Stefano; Bingisser, Roland; Tamm, Michael; Battegay, Manuel; Weisser, Maja; Stolz, Daiana; Khanna, Nina; Egli, Adrian
- Abstract
Purpose: Panel PCR tests provide rapid pathogen identification. However, their diagnostic performance is unclear. We assessed the performance of the Biofire© FilmArray pneumonia (PN)-panel against standard culture in broncho-alveolar lavage (BAL) samples. Methods: Setting: University Hospital Basel (February 2019 to July 2020), including hospitalized patients with a BAL (± pneumonia). We determined sensitivity and specificity of the PN-panel against standard culture. Using univariate logistic regression, we calculated odds ratios (OR) for pneumonia according to PN-panel and culture status, stratifying by chronic pulmonary disease. We calculated ORs for pneumonia for different pathogens to estimate the clinical relevance. Results: We included 840 adult patients, 60% were males, median age was 68 years, 35% had chronic pulmonary disease, 21% had pneumonia, and 36% had recent antibiotic use. In 1078 BAL samples, bacterial pathogens were detected in 36% and 16% with PN-panel and culture, respectively. The overall sensitivity and specificity of the PN-panel was high, whereas the positive predictive value was low. The OR of pneumonia was 1.1 (95% CI 0.7–1.6) for PN-panel-positive only; 2.6 (95% CI 1.3–5.3) for culture-positive only, and 1.6 (95% CI 1.0–2.4) for PN-panel and culture-positive. The detection rate of Haemophilus influenzae, Staphylococcus aureus, and Moraxella catarrhalis in the PN-panel was high but not associated with pneumonia. Conclusion: While sensitivity and specificity of PN-panel are high compared to culture, pathogen detection did not correlate well with a pneumonia diagnosis. Patients with culture-positive BAL had the highest OR for pneumonia—thus the impact of the PN-panel on clinical management needs further evaluation in randomized controlled trials.
- Subjects
SWEDEN; PNEUMONIA diagnosis; HOSPITAL patients; BRONCHOALVEOLAR lavage; MOLECULAR diagnosis; ACADEMIC medical centers; CONFIDENCE intervals; SCIENTIFIC observation; RESPIRATORY disease diagnosis; CULTURES (Biology); RETROSPECTIVE studies; RESEARCH funding; POLYMERASE chain reaction; SENSITIVITY &; specificity (Statistics); LOGISTIC regression analysis; ODDS ratio
- Publication
Infection, 2024, Vol 52, Issue 1, p173
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-023-02080-1