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Diagnostic accuracy of the BioFire® FilmArray® pneumonia panel in COVID-19 patients with ventilator-associated
Gabriel Cojuc-Konigsberg1,2, Alberto Moscona-Nissan3, Alberto Guijosa3
1Clinical Microbiology Laboratory, National Institute of Respiratory Diseases, Mexico City, Mexico.
Insights
The BioFire® FilmArray® Pneumonia Panel (FA-PP) is a sensitive tool for diagnosing ventilator-associated pneumonia (VAP) in COVID-19 patients. It detects more bacteria than traditional methods, aiding in faster, targeted treatment and better antibiotic stewardship.
Area of Science:
- Medical Diagnostics
- Infectious Diseases
- Critical Care Medicine
Background:
- Ventilator-associated pneumonia (VAP) significantly increases morbidity and mortality in critically ill COVID-19 patients, especially in resource-limited settings.
- Limited access to rapid diagnostic testing in lower-and-middle-income countries complicates effective VAP management.
- Urgent need for rapid microbiological diagnosis to guide therapy, prevent adverse outcomes, and combat antimicrobial resistance.
Purpose of the Study:
- To evaluate the diagnostic performance of the BioFire® FilmArray® Pneumonia Panel (FA-PP) for suspected VAP in COVID-19 patients.
- To compare the FA-PP assay results with standard microbiological culture.
- To assess the utility of FA-PP in identifying pathogens and antimicrobial resistance genes.
Main Methods:
- A cross-sectional study involving 252 patients with suspected VAP and COVID-19.
- Respiratory secretion samples were analyzed using both standard microbiological culture and the FA-PP assay.
- Comparative analysis of diagnostic accuracy, including sensitivity, specificity, and predictive values.
Main Results:
- The FA-PP detected significantly more microorganisms (277) compared to traditional culture (141), with a sensitivity of 95% and specificity of 60%.
- FA-PP showed higher sensitivity (94%) and specificity (86%) in samples with high genetic material levels (>10^5 copies/mL).
- The panel identified 98 antimicrobial resistance genes, notably extended-spectrum beta-lactamases (28%), and detected pathogens in 40% of culture-negative samples.
Conclusions:
- The FA-PP demonstrates high sensitivity for detecting VAP-causing bacteria in COVID-19 patients, outperforming conventional methods.
- Timely identification of pathogens and resistance genes by FA-PP can optimize clinical decision-making and treatment strategies.
- The assay supports improved antibiotic stewardship and tailored therapeutic interventions, crucial for managing VAP in critical care settings.
Background:
Ventilator-Associated pneumonia (VAP) is one of the leading causes of morbidity and mortality in critically ill COVID-19 patients in lower-and-middle-income settings, where timely access to emergency care and accurate diagnostic testing is not widely available. Therefore, rapid microbiological diagnosis is essential to improve effective therapy delivery to affected individuals, preventing adverse outcomes and reducing antimicrobial resistance.
Methods:
We conducted a cross-sectional study of patients with suspected VAP and COVID-19, evaluating the diagnostic performance of the BioFire® FilmArray® Pneumonia Panel (FA-PP). Respiratory secretion samples underwent standard microbiological culture and FA-PP assays, and the results were compared.
Results:
We included 252 samples. The traditional culture method detected 141 microorganisms, and FA-PP detected 277, resulting in a sensitivity of 95% and specificity of 60%, with a positive predictive value of 68% and negative predictive value of 93%. In samples with high levels of genetic material (> 10^5 copies/mL), the panel had a sensitivity of 94% and specificity of 86%. In addition, 40% of the culture-negative samples had positive FA-PP® results, of which 35% had > 10^5 copies/mL of genetic material. The most prevalent bacteria were Gram-negative bacilli, followed by Gram-positive cocci. The panel identified 98 genes associated with antimicrobial resistance, predominantly extended-spectrum beta-lactamases (28%).
Conclusion:
The FA-PP is a sensitive assay for identifying bacteria causing VAP in patients with COVID-19, with a greater capacity to detect bacteria than the conventional method. The timely microbiological recognition offered by this panel could lead to optimized decision-making processes, earlier tailored treatment initiation, and improved antibiotic stewardship practices.
