Evaluation of Microbiological Concordance of a Rapid Molecular Diagnostic Pneumonia Panel in a Real-World Population with Pneumonia

Abstract

AbstractBackgroundThe Biofire® FilmArray® Pneumonia Panel (PN Panel) provides a more rapid and sensitive method of respiratory pathogen detection than standard culture. However, it is often unclear how to apply the results clinically, especially in the case of discordant culture results. We evaluated the concordance of bacterial organism and resistance gene identification between the PN Panel and standard culture methods in hospitalized patients with a clinical diagnosis of pneumonia.MethodsThis single-center retrospective observational study of 274 inpatients assessed the positive predictive value (PPV) and described the prevalence of individual bacterial organism and resistance marker targets on the PN Panel.ResultsThe overall PPV of the PN Panel in identifying bacteria was 70.1%, with individual organism PPV ranging from 50.0% to 90.9%. For resistance gene identification, the PN Panel’s PPV ranged from 46.2% for CTX-M to 68.4% for mecA/C and the staphylococcal cassette chromosome mec element right extremity junction (MREJ), although resistance was uncommon. Staphylococcus aureus was the most common bacterial pathogen detected by the PN Panel (38.7%), followed by Pseudomonas aeruginosa (22.3%), and Haemophilus influenzae (12.0%).ConclusionsThe PN Panel detected more bacteria and resistance gene targets than standard culture methods. To optimize the use of this technology for both patient care and antimicrobial stewardship, results should be coupled with clinical assessment and clinician education.