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Updated: Oct 22, 2025
Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Relationship of Multiplex Molecular Pneumonia Panel Results With Hospital Outcomes and Clinical Variables
K H Rand1, S G Beal1, K Cherabuddi1
1University of Florida, Gainesville, Florida, USA.
Background:
Antibiotic treatment decisions in severely ill patients must often be made in the absence of microbiologic results. The recently Food and Drug Administration-cleared BioFire FilmArray Pneumonia Panel (PN) detects 15 bacteria semiquantitatively, 3 atypical pneumonia bacteria, 8 viruses, and 7 antimicrobial resistance markers by multiplex PCR in ~1 hour in the laboratory. Previous reports have shown that the PN Panel bacterial detections are highly accurate, even when routine culture had no growth.
Methods:
Consecutive bronchoalveolar lavage and endotracheal specimens submitted for culture between June and September 2018 from 270 patients with sufficient clinical and laboratory data were tested with the PN Panel. Patients were divided into 3 groups: (1) both culture and PN Panel positive, (2) PN Panel positive but culture uninformative (no growth or normal flora), and (3) patients with no PN Panel detections.
Results:
Groups 1 and 2 had significantly higher maximum temperatures on the day of culture (P = .00036, analysis of variance [ANOVA] with Bonferroni correction), higher levels of an inflammatory response as measured by percent polymorphonuclear leukocytes in bronchoalveolar lavage (P = .00025, ANOVA with Bonferroni correction), and gram stain report of white blood cells, as previously reported [1].
Conclusions:
Both group 1 (culture and PN Panel positive), and group 2 (PN Panel positive but culture uninformative) had higher levels of host response inflammatory responses compared with group 3, which had no targets detected, suggesting that PN Panel detections need to be interpreted in the clinical context, even if cultures are discordant. Depending on laboratory turnaround time, there could be opportunities for improved diagnosis and antibiotic stewardship.
Insights
The BioFire FilmArray Pneumonia Panel (PN) aids in diagnosing pneumonia by detecting pathogens and resistance markers. PN Panel results, when interpreted with clinical context, can improve antibiotic stewardship, even with discordant culture results.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Diagnostic Technology
Background:
- Empirical antibiotic treatment is common in severe infections due to delayed microbiologic results.
- The BioFire FilmArray Pneumonia Panel (PN) offers rapid multiplex PCR detection of respiratory pathogens and antimicrobial resistance markers.
- Previous studies indicate high accuracy for PN Panel bacterial detections, even when standard cultures are negative.
Purpose of the Study:
- To evaluate the clinical utility of the BioFire FilmArray Pneumonia Panel (PN) in diagnosing pneumonia.
- To compare host inflammatory responses between patients with positive PN Panel results and those with no detections.
- To assess the potential for improved diagnosis and antibiotic stewardship using the PN Panel.
Main Methods:
- A prospective study involving 270 patients with bronchoalveolar lavage and endotracheal specimens.
- Specimens were tested using both conventional culture and the BioFire FilmArray Pneumonia Panel (PN).
- Patients were categorized into three groups based on PN Panel and culture results: both positive, PN Panel positive/culture uninformative, and no PN Panel detections.
Main Results:
- Patients with positive PN Panel results (groups 1 and 2) exhibited significantly higher maximum temperatures and inflammatory markers (polymorphonuclear leukocytes) compared to those with no detections (group 3).
- These findings were statistically significant using analysis of variance (ANOVA) with Bonferroni correction.
- Gram stain reports of white blood cells also correlated with positive PN Panel results.
Conclusions:
- PN Panel detections, even if discordant with culture, are associated with heightened host inflammatory responses.
- Interpretation of PN Panel results within the clinical context is crucial for accurate diagnosis.
- The rapid turnaround time of the PN Panel presents opportunities for enhanced diagnostic accuracy and antibiotic stewardship.
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