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Respiratory infections: what to expect from molecular tools?

Evaluation of BIOFIRE® FILMARRAY® Pneumonia Plus for the detection of pathogen bacteria in respiratory infections

April 21 • P4378

B. Palop1, M.P. Bermúdez Ruiz1, M. Valverde Troya1, A.M. Fernández1, C. Mediavilla1, I. De Toro Peinado1

1) Regional University Hospital in Malaga., Málaga, Spain

Background: The objective of this study is to evaluate the usefulness of BIOFIRE® FILMARRAY® Pneumonia Plus Panel (bioMérieux, France) for detection of pathogenic bacteria in patients with community and nosocomial respiratory infections.

Materials/methods: From October-2018 to October-2019, we studied respiratory samples from 60 patients prospectively: 6 children and 54 adults. Only one sample per patient was included: 32 sputum, 20 BAS and 8 BAL. The results obtained with BIOFIRE® FILMARRAY® Pneumonia plus Panel (PNplus Panel) were compared with those obtained in the conventional culture and Real Cycler® Molecular Progenie PCR (RCPM) for Legionella pneumophila and Mycoplasma pneumoniae/Chlamydia pneumoniae.

Results: Of the 60 samples processed, 23 samples obtained negative results with PNplus Panel, with no pathogen found in the culture. We detected a bacterial pathogen with PNplus Panel in 37 samples, some of them in coinfection: 10 H. influenzae, 8 S. pneumoniae, 6 P. aeruginosa, 4 S. aureus, 3 M. catarrhalis, 7 enterobacteria, 2 Legionella pneumophila, 2 Mycoplasma pneumoniae and 1 Chlamydia pneumoniae. In 16 of these cases, the same bacteria was detected in the culture (43.2%), with a difference of 1-2 logarithms less between the CFU isolated in the culture respect to the copies/ml in PNplus Panel. In the 21 samples with no pathogens isolated in culture, the following microorganisms were detected with PNplus Panel: 8 H. influenzae, 6 S. pneumoniae, 5 S. aureus, 3 P. aeruginosa, 3 K. pneumoniae, 2 M. catarrhalis, 1 K. oxytoca and 1 E. coli. 13 of these 21 samples corresponded to patients who had received antibiotic treatment in the previous 24 hours (61.9%). Legionella pneumophila was detected in two samples, the result of the culture, the RCPM and the detection of antigen in urine being negative. Mycoplasma pneumoniae was detected in two samples and Chlamydia pneumoniae in one sample, the three cases being confirmed by RCPM. There was no culture with pathogenic microorganisms not detected with PNplus Panel.

Conclusions: PNplus Panel seems to be a useful tool for the etiological diagnosis of respiratory infections, improving sensitivity and rapidity against the culture, especially in patients who have received previous antibiotic treatment. Correlation studies with culture counts are necessary to establish cut-off points in the quantification of PNplus Panel that allow us to manage this new tool.

filmarray

Pneumonia Panel

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