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. 2021 Jul 23;101(3):115507. doi: 10.1016/j.diagmicrobio.2021.115507

Table 2.

Bacteriological results according to the type of pneumonia and contribution of the panel FAPP on antibiotic prescription

Samples (n = 119)
CAP VAP
Type of suspected pneumonia 27 (22.7) 92 (77.3)
Confirmed diagnostic of pneumonia
(% among suspected / % among total)		 6
(22.2 / 5.0)		 48
(52.2 / 40.3)
Type of samples:
 ETA
 BAL
15
12
59
33
Antibiotics 48h prior to samples (n = 55) 15 (55.6) 40 (43.5)
Bacterial copathogens:
  Staphylococcus aureus
  Pseudomonas aeruginosa
  Haemophilus influenzae
  Escherichia coli
  Klebsiella pneumoniae
  Enterobacter cloacae
  Klebsiella aerogenes
  Proteus spp.
  Serratia marcescens
  Streptococcus agalactiae
  Moraxella catarrhalis
 Mycoplasma pneumoniae
 Morganella morganii
 Hafnia alvei
 Providencia stuartii 		FAPP / CC
0 / 0
0 / 0
4 / 0
0 / 0
1 / 1
0 / 0
0 / 0
0 / 0
0 / 0
0 / 0
1 / 0
1 / NA
NA / 0
NA / 0
NA / 0		 FAPP / CC
17 / 12
11 / 11
6 / 3
9 / 5
6 / 6
5 / 5
4 / 2
4 / 3
3 / 3
3 / 1
1 / 1
0 / NA
NA / 2
NA / 1a
NA / 1a
Resistance detection:
 MRSA
 3GC-R Gram-negative bacilli		 FAPP / AST
0 / 0
0 / 0		 FAPP / AST
6 / 0
5 / 6b
Type of pneumonia CAP VAP
Contribution of FAPP at first intensivist decisionc
 No modification of empirical antibiotics
 Speeded-up adequate antibiotic
 Antibiotic spared
 Inappropriate antibiotic treatment
 Inappropriate stopped antibiotic

0
2 (20.0)
8 (80.0)
0
0

3 (7.5)
9 (22.5)
20 (50.0)
7 (17.5)
1 (2.5)
Contribution of FAPP based on MEC analysise
 No modification of empirical antibiotics
 Speeded-up adequate antibiotic
 Antibiotic spared
 Inappropriate antibiotic treatment
 Inappropriate stopped antibiotic
1 (3.7)
4 (14.8)
22 (81.5)
0
0
11 (12.0)
13 (14.1)
56 (60.9)
10 (10.9)
2 (2.2)

Data are presented as: n (%).

ETA = endotracheal aspirate; BAL = bronchoalveolar lavage; CAP = community-acquired pneumonia (defined as infections occurring during the first 48h of ICU admission); VAP = ventilator-associated pneumonia; FAPP = FilmArray® Pneumonia Panel; CC = conventional culture; AST = antimicrobial susceptibility testing; MRSA = methicillin-resistant S. aureus; 3GC-R = third generation cephalosporins resistance; NA = not applicable (species not detected either by the FAPP or by the CC); MEC = multidisciplinary expert committee.

a The isolation of H. alvei and P. stuartii in CC had no impact on antibiotic therapy as they were covered by the antibiotics administered following the detection of other pathogens detected by FAPP.

b Among 3GC-resistant Gram-negative bacilli, 3 CTX-M were detected by both FAPP and CC, 2 CTX-M were detected only by FAPP, 2 ESBL not belonging to CTX-M as well as one 3GC-resistant P. aeruginosa were detected only by CC.

c A contribution of FAPP at first intensivist decision was noted in 50 samples (42.0%).

d Decrease unnecessary antibiotic use (interruption or de-escalation).

e Theoretical contribution of FAPP after MEC analysis of the 119 samples (100.0%).