Performance of PCR-based syndromic testing compared to bacterial culture in patients with suspected pneumonia applying microscopy for quality assessment
(2022) In APMIS : acta pathologica, microbiologica, et immunologica Scandinavica 130(7). p.417-426- Abstract
Syndromic testing for lower respiratory tract infections with BioFire® FilmArray® Pneumonia Panel Plus (BF) detects 27 pathogens with a turn-around-time of one hour. We compared the performance of BF with culture. Samples from 298 hospitalized patients with suspected pneumonia routinely sent for culture were also analyzed using BF. Retrospectively, patients were clinically categorized as having "pneumonia" or "no pneumonia." BF and culture were compared by analytical performance, which was evaluated by pathogen concordance, and by clinical performance by comparing pathogen detections in patients with and without pneumonia. The BF results for viruses and atypical bacteria were not included in the performance analysis. In 298 patient... (More)
Syndromic testing for lower respiratory tract infections with BioFire® FilmArray® Pneumonia Panel Plus (BF) detects 27 pathogens with a turn-around-time of one hour. We compared the performance of BF with culture. Samples from 298 hospitalized patients with suspected pneumonia routinely sent for culture were also analyzed using BF. Retrospectively, patients were clinically categorized as having "pneumonia" or "no pneumonia." BF and culture were compared by analytical performance, which was evaluated by pathogen concordance, and by clinical performance by comparing pathogen detections in patients with and without pneumonia. The BF results for viruses and atypical bacteria were not included in the performance analysis. In 298 patient samples, BF and culture detected 285 and 142 potential pathogens, respectively. Positive percent agreement (PPA) was 88% (125/142). In patients with community-acquired pneumonia (CAP), clinical sensitivity was 70% and 51%, and specificity was 43% and 71% for BF and culture, respectively. In patients with hospital-acquired pneumonia, the corresponding numbers were 55% and 23%, and 47% and 68%. There was no significant improvement of performance, when only high-quality sputum samples were considered. Efficacy of both BF and culture was low. Both tests are best used in CAP patients for whom the diagnosis has already been clinically established. Indiscriminate use may be clinically misleading and a cause of improper use of antibiotics.
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- author
- Andrews, Vigith LU ; Pinholt, Mette ; Schneider, Uffe Vest ; Schønning, Kristian ; Søes, Lillian Marie and Lisby, Gorm
- publishing date
- 2022-07
- type
- Contribution to journal
- publication status
- published
- keywords
- Community-Acquired Infections/diagnosis, Humans, Microscopy, Molecular Diagnostic Techniques/methods, Multiplex Polymerase Chain Reaction/methods, Pneumonia/diagnosis, Polymerase Chain Reaction, Retrospective Studies
- in
- APMIS : acta pathologica, microbiologica, et immunologica Scandinavica
- volume
- 130
- issue
- 7
- pages
- 417 - 426
- publisher
- Blackwell Munksgaard
- external identifiers
-
- pmid:35499302
- scopus:85130266362
- ISSN
- 0903-4641
- DOI
- 10.1111/apm.13232
- language
- English
- LU publication?
- no
- additional info
- © 2022 Scandinavian Societies for Medical Microbiology and Pathology.
- id
- 91b78c21-6a70-42de-ad7b-552a40003ffd
- date added to LUP
- 2024-09-12 10:06:43
- date last changed
- 2025-07-05 08:34:40
@article{91b78c21-6a70-42de-ad7b-552a40003ffd,
abstract = {{<p>Syndromic testing for lower respiratory tract infections with BioFire® FilmArray® Pneumonia Panel Plus (BF) detects 27 pathogens with a turn-around-time of one hour. We compared the performance of BF with culture. Samples from 298 hospitalized patients with suspected pneumonia routinely sent for culture were also analyzed using BF. Retrospectively, patients were clinically categorized as having "pneumonia" or "no pneumonia." BF and culture were compared by analytical performance, which was evaluated by pathogen concordance, and by clinical performance by comparing pathogen detections in patients with and without pneumonia. The BF results for viruses and atypical bacteria were not included in the performance analysis. In 298 patient samples, BF and culture detected 285 and 142 potential pathogens, respectively. Positive percent agreement (PPA) was 88% (125/142). In patients with community-acquired pneumonia (CAP), clinical sensitivity was 70% and 51%, and specificity was 43% and 71% for BF and culture, respectively. In patients with hospital-acquired pneumonia, the corresponding numbers were 55% and 23%, and 47% and 68%. There was no significant improvement of performance, when only high-quality sputum samples were considered. Efficacy of both BF and culture was low. Both tests are best used in CAP patients for whom the diagnosis has already been clinically established. Indiscriminate use may be clinically misleading and a cause of improper use of antibiotics.</p>}},
author = {{Andrews, Vigith and Pinholt, Mette and Schneider, Uffe Vest and Schønning, Kristian and Søes, Lillian Marie and Lisby, Gorm}},
issn = {{0903-4641}},
keywords = {{Community-Acquired Infections/diagnosis; Humans; Microscopy; Molecular Diagnostic Techniques/methods; Multiplex Polymerase Chain Reaction/methods; Pneumonia/diagnosis; Polymerase Chain Reaction; Retrospective Studies}},
language = {{eng}},
number = {{7}},
pages = {{417--426}},
publisher = {{Blackwell Munksgaard}},
series = {{APMIS : acta pathologica, microbiologica, et immunologica Scandinavica}},
title = {{Performance of PCR-based syndromic testing compared to bacterial culture in patients with suspected pneumonia applying microscopy for quality assessment}},
url = {{http://dx.doi.org/10.1111/apm.13232}},
doi = {{10.1111/apm.13232}},
volume = {{130}},
year = {{2022}},
}