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Identification of bacterial co-detections in COVID-19 critically Ill patients by BioFire® FilmArray® pneumonia panel:
Tristan T Timbrook1, Kyle D Hueth2, Christine C Ginocchio3
1BioFire Diagnostics, LLC, Salt Lake City, Utah, USA; College of Pharmacy, University of Utah Health, Salt Lake City, Utah, USA.
Abstract:
Among critically ill COVID-19 patients, bacterial coinfections may occur, and timely appropriate therapy may be limited with culture-based microbiology due to turnaround time and diagnostic yield challenges (e.g. antibiotic pre-exposure). We performed a systematic review and meta-analysis of the impact of BioFire® FilmArray® Pneumonia Panel in detecting bacteria and clinical management among critically ill COVID-19 patients admitted to the ICU. Seven studies with 558 patients were included. Antibiotic use before respiratory sampling occurred in 28-79% of cases. The panel incidence of detections was 33% (95% CI 0.25 to 0.41, I2=32%) while culture yielded 18% (95% CI 0.02 to 0.45; I2=93%). The panel was associated with approximately a 1 and 2 day decrease in turnaround for identification and common resistance targets, respectively. The panel may be an important tool for clinicians to improve antimicrobial use in critically ill COVID-19 patients.
Insights
The BioFire® FilmArray® Pneumonia Panel detects more bacteria in critically ill COVID-19 patients than traditional cultures. This rapid molecular test aids in faster diagnosis and improved antimicrobial stewardship.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Molecular Diagnostics
Background:
- Bacterial coinfections are a concern in critically ill COVID-19 patients.
- Culture-based microbiology faces limitations like long turnaround times and challenges with prior antibiotic use.
Purpose of the Study:
- To systematically review and meta-analyze the impact of the BioFire® FilmArray® Pneumonia Panel.
- To evaluate its effectiveness in detecting bacteria and guiding clinical management in ICU-admitted COVID-19 patients.
Main Methods:
- Systematic review and meta-analysis of seven studies.
- Inclusion of 558 critically ill COVID-19 patients.
Main Results:
- The panel detected bacteria in 33% of cases, compared to 18% with culture.
- The panel reduced turnaround time for identification and resistance targets by 1-2 days.
- High rates of pre-sampling antibiotic use (28-79%) were observed.
Conclusions:
- The BioFire® FilmArray® Pneumonia Panel offers improved bacterial detection over cultures.
- It may be a valuable tool for optimizing antimicrobial use in critically ill COVID-19 patients.
- Faster results can potentially improve patient outcomes.
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