Enhanced Detection of Community-Acquired Pneumonia Pathogens With the BioFire® Pneumonia FilmArray® Panel.

Area of Science:

• Clinical Microbiology
• Infectious Diseases
• Respiratory Medicine

Background:

• Community-acquired pneumonia (CAP) diagnosis often lacks pathogen identification in standard observational studies.
• Previous work showed a multi-test bundle (MTB) improved pathogen detection rates in CAP patients.
• This study evaluates the Biofire® Pneumonia FilmArray® panel (BPFA) against the MTB for pathogen detection in CAP.

Purpose of the Study:

• Compare pathogen detection rates between the BPFA and MTB in hospitalized CAP patients.
• Assess the utility of BPFA results for guiding antibiotic stewardship (AS) decisions.
• Evaluate the role of procalcitonin (PCT) in differentiating bacterial colonization from infection.

Main Methods:

• Prospective enrollment of CAP patients between January 2017 and March 2018.
• Evaluated 274 patients who completed both MTB and BPFA testing.
• Primary endpoint: percentage of potential pathogens detected by MTB (8 viral, 6 bacterial) versus BPFA (8 viral, 18 bacterial).

Main Results:

• BPFA detected viral pathogens in 60.9% of patients compared to 40.5% with MTB (OR 9.00, p<0.01).
• BPFA identified bacterial pathogens in 75.5% of patients versus 66.4% with MTB (OR 2.09, p=0.003).
• Low procalcitonin (PCT) levels assisted in identifying detected bacteria as colonizers rather than invasive pathogens.

Conclusions:

• The BPFA demonstrates superior performance in detecting both viral and bacterial pathogens in CAP compared to the MTB.
• Enhanced pathogen identification by BPFA provides a stronger foundation for targeted antibiotic stewardship.
• Utilizing PCT levels alongside multiplex PCR panels can refine clinical assessment of bacterial presence in CAP.