Performance of a Semiquantitative Multiplex Bacterial and Viral PCR Panel Compared With Standard Microbiological Laboratory Results: 396 Patients Studied With the BioFire Pneumonia Panel
Open Access
- 31 December 2020
- journal article
- research article
- Published by Oxford University Press (OUP) in Open Forum Infectious Diseases
- Vol. 8 (1), ofaa560
- https://doi.org/10.1093/ofid/ofaa560
Abstract
Background. Microbiologic results are critical to optimal management of patients with lower respiratory tract infection, but standard methods may take several days. The multiplex polymerase chain reaction BioFire Pneumonia (PN) panel detects 15 common bacterial species scmiquantitatively as copy number/mL, 8 viral species, and 7 resistance genes in about an hour within the clinical laboratory. Methods. We tested 396 unique endotracheal or bronchoalveolar lavage specimens with the BioFire Pneumonia panel and compared the bacterial detections to conventional gram stain and culture results. Results. Of the 396 patients, 138 grew at least 1 bacterium that had a target on the PN panel, and 136/138 (98.6%) were detected by the panel. A total of 177 isolates were recovered in culture and the PN panel detected 174/177 (98.3%). A further 20% of patients had additional targets detected that were not found on standard culture (specificity 69%, positive predictive value 63%, and negative predictive value 98.9%). Copy number was strongly related to standard semiquantitative growth on plates reported by the laboratory (cg, 1+, 2+, 3+ growths) and was significantly higher in those specimens that grew a potential pathogen. Both higher copy number and bacterial detections found by the PN panel, but not found in culture, were strongly positively related to the level of white blood cells reported in the initial gram stain. Conclusions. Higher copy number and bacterial detections by the PN panel are related to the host respiratory tract inflammatory response. If laboratories can achieve a rapid turnaround time, the PN panel should have a significant impact both on patient management and on antibiotic stewardship.Keywords
Funding Information
- BioFire Diagnostics
This publication has 16 references indexed in Scilit:
- Multicenter Evaluation of the Portrait Staph ID/R Blood Culture Panel for Rapid Identification of Staphylococci and Detection of the mecA GeneJournal of Clinical Microbiology, 2017
- Impact of bronchoalveolar lavage multiplex polymerase chain reaction on microbiological yield and therapeutic decisions in severe pneumonia in intensive care unitJournal of Critical Care, 2015
- Development of two real-time multiplex PCR assays for the detection and quantification of eight key bacterial pathogens in lower respiratory tract infectionsClinical Microbiology & Infection, 2015
- Driving Forces of Mechanisms Regulating Oxacillin-Resistance Phenotypes of MRSA: Truly Oxacillin-Susceptible mecA-Positive Staphylococcus aureus Clinical Isolates also ExistCurrent Pharmaceutical Design, 2015
- Multiplex PCR performed of bronchoalveolar lavage fluid increases pathogen identification rate in critically ill patients with pneumonia: a pilot studyAnnals of Intensive Care, 2014
- Usefulness of Cellular Analysis of Bronchoalveolar Lavage Fluid for Predicting the Etiology of Pneumonia in Critically Ill PatientsPLOS ONE, 2014
- Clinical Evaluation of the FilmArray Blood Culture Identification Panel in Identification of Bacteria and Yeasts from Positive Blood Culture BottlesJournal of Clinical Microbiology, 2013
- High Proportion of Wrongly Identified Methicillin-Resistant Staphylococcus aureus Carriers by Use of a Rapid Commercial PCR Assay Due to Presence of Staphylococcal Cassette Chromosome Element Lacking the mecA GeneJournal of Clinical Microbiology, 2011
- In Vitro and In Vivo Evaluations of Oxacillin Efficiency against mecA -Positive Oxacillin-Susceptible Staphylococcus aureusAntimicrobial Agents and Chemotherapy, 2008
- The role of multiplex PCR test in identification of bacterial pathogens in lower respiratory tract infections.Pakistan Journal of Medical Sciences, 1969