BioFire® FilmArray® Pneumonia Panel for Severe Lower Respiratory Tract Infections: Subgroup Analysis of a Randomized Clinical Trial
Evdoxia Kyriazopoulou, Athanasios Karageorgos, Lydia Liaskou-Antoniou, Panagiotis Koufargyris, Asimina Safarika, Georgia Damoraki, Vasileios Lekakis, Maria Saridaki, George Adamis, Evangelos J. Giamarellos‐Bourboulis
Abstract
The epidemiology of severe lower respiratory tract infections (LRTI) is constantly changing. We aimed to describe it using the BioFire ® FilmArray ® Pneumonia plus (PN plus ) Panel. In a sub-study of the PROGRESS trial, sputum samples of 90 patients with sepsis and LRTI were retrospectively studied. The primary endpoint was the comparative detection rate of pathogens between conventional microbiology and PN plus Panel; secondary endpoints were microbiology and the association with the inflammatory host response. Fifty-six patients with community-acquired pneumonia without risk factors for multidrug-resistant (MDR) pathogens and another 34 patients with risk factors for MDR were studied; median pneumonia severity index (PSI) was 113 (88–135). PN plus detection rate was 72.2% compared to 10% by conventional microbiology ( p < 0.001); Streptococcus pneumoniae was the most common pathogen. PSI and procalcitonin were greater among patients with bacterial pathogens than viral pathogens. Median procalcitonin was 0.49 ng/ml and 0.18 ng/ml among patients with ≥ 10 5 and < 10 5 copies/ml of detected bacteria, respectively ( p = 0.004). Resistance reached 14.4%. PN plus detects severe pneumonia pathogens at a greater rate than conventional microbiology. High levels of inflammation accompany bacterial detection. PROGRESS, ClinicalTrials.gov NCT03333304, 06/11/2017.