Practical comparison of the BioFire FilmArray pneumonia panel to routine diagnostic methods and potential impact on antimicrobial stewardship in adult hospitalized patients with lower respiratory tract infections

Blake W. Buchan, Sam Windham, Joan Miquel Balada-Llasat, Amy Leber, Amanda Harrington, Ryan Relich, Caitlin Murphy, Jennifer Dien Bard, Samia Naccache, Shira Ronen, Amanda Hopp, Derya Mahmutoglu, Matthew L. Faron, Nathan A. Ledeboer, Amanda Carroll, Hannah Stone, Oluseun Akerele, Kathy Everhart, Andrew Bonwit, Christina KwongRebecca Buckner, Del Warren, Randal Fowler, Sukantha Chandrasekaran, Holly Huse, Shelley Campeau, Romney Humphries, Corrin Graue, Angela Huang

Research output: Contribution to journalArticle

Abstract

Lower respiratory tract infections, including hospital-acquired and ventilator-associated pneumonia, are common in hospitalized patient populations. Standard methods frequently fail to identify the infectious etiology due to the polymicrobial nature of respiratory specimens and the necessity of ordering specific tests to identify viral agents. The potential severity of these infections combined with a failure to clearly identify the causative pathogen results in administration of empirical antibiotic agents based on clinical presentation and other risk factors. We examined the impact of the multiplexed, semiquantitative BioFire FilmArray Pneumonia panel (PN panel) test on laboratory reporting for 259 adult inpatients submitting bronchoalveolar lavage (BAL) specimens for laboratory analysis. The PN panel demonstrated a combined 96.2% positive percent agreement (PPA) and 98.1% negative percent agreement (NPA) for the qualitative identification of 15 bacterial targets compared to routine bacterial culture. Semiquantitative values reported by the PN panel were frequently higher than values reported by culture, resulting in semiquantitative agreement (within the same log10 value) of 43.6% between the PN panel and culture; however, all bacterial targets reported as >105 CFU/ml in culture were reported as ≥105 genomic copies/ml by the PN panel. Viral targets were identified by the PN panel in 17.7% of specimens tested, of which 39.1% were detected in conjunction with a bacterial target. A review of patient medical records, including clinically prescribed antibiotics, revealed the potential for antibiotic adjustment in 70.7% of patients based on the PN panel result, including discontinuation or deescalation in 48.2% of patients, resulting in an average savings of 6.2 antibiotic days/ patient.

Original languageEnglish (US)
Article numbere00135-20
JournalJournal of clinical microbiology
Volume58
Issue number7
DOIs
StatePublished - Jul 2020

Keywords

  • Medical outcomes
  • Multiplex
  • Pneumonia
  • Stewardship

ASJC Scopus subject areas

  • Microbiology (medical)

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    Buchan, B. W., Windham, S., Balada-Llasat, J. M., Leber, A., Harrington, A., Relich, R., Murphy, C., Bard, J. D., Naccache, S., Ronen, S., Hopp, A., Mahmutoglu, D., Faron, M. L., Ledeboer, N. A., Carroll, A., Stone, H., Akerele, O., Everhart, K., Bonwit, A., ... Huang, A. (2020). Practical comparison of the BioFire FilmArray pneumonia panel to routine diagnostic methods and potential impact on antimicrobial stewardship in adult hospitalized patients with lower respiratory tract infections. Journal of clinical microbiology, 58(7), [e00135-20]. https://doi.org/10.1128/JCM.00135-20