Background: Following international recommendations, patients suspected with severe pneumonia receive broad-spectrum empirical antibiotherapy subsequently reviewed upon availability of microbiological results. However laboratory analysis on respiratory samples requires up to 48 hours to obtain final results allowing instauration of optimal antibiotherapy (OAT). Molecular testing aims to reduce time to results. In this study we evaluated the microbiological performances and clinical impact of the BIOFIRE® FILMARRAY® Pneumonia plus Panel (PNplus Panel) (bioMérieux) on critically ill suspected with severe pneumonia. This multiplex PCR allows the detection of 27 bacteria and viruses within 1h15 minutes directly from the respiratory sample.
Materials/methods: This prospective interventional study is conducted at the Cliniques universitaires Saint-Luc university hospital. Conditions for inclusion are: all adult patients admitted/remaining at the intensive care with suspicion of community acquired pneumonia class IV (CAP IV) or hospital acquired pneumonia (HAP) for which a lower respiratory tract sample was obtained. The study started in May 2019 and will last for 1 year. PNplus Panel testing is performed immediately following sample collection 24h/24 7days/7. Results were compared with routine testing including urinary antigen detection, immuno-enzymatic viral assays and bacterial cultures performed during working hours. PNplus Panel results were used to tailor patient’s antimicrobial treatment and time to OAT was measured.
Results: At present 34 patients have been included, comprising 20 men and 14 women with a mean age of 63 years. Final diagnosis was bacterial CAP IV and HAP for respectively 15 and 9 patients while pneumonia diagnosis was uncorroborated for 10 patients. Mean time to PNplus Panel result was 2h10 compared to 52h to complete routine laboratory results. A 100% concordance with routine testing was observed for all PNplus Panel strains detected with a minimum quantity of 106 copies/ml. 18/34 (52.9%) included patients benefitted from a speeded-up initiation of OAT following PNplus Panel result availability consisting of 11 cases of antibiotic streamlining and 7 cases of complete antibiotic stop.
Conclusions: PNplus Panel results show optimal concordance with routine testing and speed up instauration of the OAT in more than 50% of the included patients. Incoming study results confirm these observations and will be included in the presentation.