AUTHOR=Crémet Lise , Gaborit Benjamin , Bouras Marwan , Drumel Thomas , Guillotin Florian , Poulain Cécile , Persyn Elise , Lakhal Karim , Rozec Bertrand , Vibet Marie-Anne , Roquilly Antoine , Gibaud Sophie 

TITLE=Evaluation of the FilmArray® Pneumonia Plus Panel for Rapid Diagnosis of Hospital-Acquired Pneumonia in Intensive Care Unit Patients

JOURNAL=Frontiers in Microbiology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2020.02080

DOI=10.3389/fmicb.2020.02080

ISSN=1664-302X

ABSTRACT=<p>The FilmArray<sup>®</sup> Pneumonia <italic>plus</italic> Panel (FAPP) is a new multiplex molecular test for hospital-acquired pneumonia (HAP), which can rapidly detect 18 bacteria, 9 viruses, and 7 resistance genes. We aimed to compare the diagnosis performance of FAPP with conventional testing in 100 intensive care unit (ICU) patients who required mechanical ventilation, with clinically suspected HAP. A total of 237 samples [76 bronchoalveolar lavages (BAL<sub>DS</sub>) and 82 endotracheal aspirates (ETA<sub>DS</sub>) obtained at HAP diagnosis, and 79 ETA obtained during follow-up (ETA<sub>TT</sub>)], were analyzed independently by routine microbiology testing and FAPP. 58 patients had paired BAL<sub>DS</sub> and ETA<sub>DS</sub>. The positivity thresholds of semi-quantified bacteria were 10<sup>3</sup>–10<sup>4</sup> CFUs/mL or 10<sup>4</sup> copies/mL for BAL, and 10<sup>5</sup> CFUs/mL or copies/mL for ETA. Respiratory commensals (<italic>H. influenzae</italic>, <italic>S. aureus</italic>, <italic>E. coli</italic>, <italic>S. pneumoniae</italic>) were the most common pathogens. Discordant results for bacterial identification were observed in 33/76 (43.4%) BAL<sub>DS</sub> and 36/82 (43.9%) ETA<sub>DS</sub>, and in most cases, FAPP identified one supplemental bacteria (23/33 BAL<sub>DS</sub> and 21/36 ETA<sub>DS</sub>). An absence of growth, or polybacterial cultures, explained almost equally the majority of the non-detections in culture. No linear relationship was observed between bin and CFUs/mL variables. Concordant results between paired BAL<sub>DS</sub> and ETA<sub>DS</sub> were obtained in 46/58 (79.3%) patients with FAPP. One of the 17 resistance genes detected with FAPP (<italic>mecA/C</italic> and MREJ) was not confirmed by conventional testing. Overall, FAPP enhanced the positivity rate of diagnostic testing, with increased recognition of coinfections. Implementing this strategy may allow clinicians to make more timely and informed decisions.</p>