Background The FilmArray Pneumonia Panel plus (PPplus) is an in vitro multiplex nucleic acid diagnostic test for the simultaneous detection and identification of multiple lower respiratory viral and bacterial Nucleic acids, as well as select antimicrobial resistance genes. It is a rapid test (∼60-min) detect 28 pathogens directly from bronchoalveolar lavage (BAL), endotracheal aspirates and sputum samples.
Methods A total of 60 clinical specimens were tested by microbiology cultured as well as Biofire Filmarray. all samples were lower respiratory, 13 Sputum (including Tracheal Aspirate and Endotracheal aspirate).
In the (PPplus), the organisms identified are classified in to 4 groups:
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a.
Bacteria are reported semi-quantitative:Acinetobacter calcoaceticus-baumannii complex, Klebsiella oxytoca, Serratia marcescens, Enterobacter cloacae complex, Klebsiella pneumoniae group, Staphylococcus aureus, Escherichia coli, Moraxella catarrhalis, Streptococcus agalactiae, Haemophilus influenza, Proteus spp. Streptococcus pneumonia, Klebsiella aerogenes, Pseudomonas aeruginosa and Streptococcus pyogenes.
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b.
Atypical Bacteria:Chlamydia pneumonia, Legionella pneumophila and Mycoplasma pneumonia.
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c.
Viruses:Adenovirus, Human Rhinovirus/Enterovirus, Middle East Respiratory Syndrome Coronavirus (MERS-CoV), Coronavirus, Influenza A, Parainfluenza Virus, Human Metapneumovirus, Influenza B and RSV.
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d.
d. Antimicrobial Resistance Genes:CTX-M, NDM, mecA/C and MREJ, IMP, OXA-48-like, KPC and VIM.In this study, we are evaluating the performance and accuracy of (PPplus) in comparison to our clinical Microbiology standard procedure Respiratory Culture.
Result In this study, 53 organisms were detected by (PPplus) .... see table...
The overall success rate for initial specimen tests in this study was 100% positive percent agreement with previous Microbiology results and the negative percent agreement was 95%.
Conclusion Rapid molecular test can identify the causative pathogens along with early detection of resistance gene.
The clinical impact of rapid bacterial identification and antimicrobial resistance gene could reduce the overuse of antimicrobial, lower mortality and major impact on outcome of hospitalized patient with infection.