12/18/2023 0 Comments Biofire diagnostics![]() In this study, we compare the results of BioFire® FilmArray® Pneumonia Panel (BioFire Diagnostics, Salt Lake City, Utah, United States), a multiplex polymerase chain reaction (PCR) assay with those of the standard microbiologic workup on bronchoalveolar lavage (BAL) specimens collected from immunocompromised patients with evidence of pneumonia. In the context of the coronavirus disease 2019 (COVID-19) pandemic, the need for rapid and sensitive diagnostics to evaluate for bacterial superinfection is even more crucial, especially in mechanically ventilated patients, both to guide pathogen-directed therapy and to also avoid over-utilization of antibiotics. ![]() Although the 2019 Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) guidelines do not recommend routine microbiologic workup in patients hospitalized with community-acquired pneumonia, they do recommend a tiered approach to diagnostic evaluation with non-invasive and invasive microbiologic workup in immunocompromised hosts, such as bone marrow and solid organ transplant recipients. Pneumonia has been the most common cause of hospitalization due to infectious disease in the United States and the second most common cause of hospitalization overall. There is a potential benefit for performing multiplex PCR assays as an additive diagnostic tool in BAL samples for these patients. Limited data exist specifically looking at immunocompromised patients, in whom a timely and accurate diagnosis is particularly important. Studies have established the additive role of multiplex PCR testing in addition to traditional diagnostic tools like sputum culture in diagnosing the etiology of pneumonia. ![]() The median time to de-escalation of antimicrobials was three days (interquartile range (IQR) 2-4) from the day of collection of the BAL samples. In four cases, the multiplex PCR assay identified a possible causative pathogen not detected by standard workup. BAL culture results and the multiplex PCR assay were in agreement in 13 samples (76.5%). Seventeen individual BAL samples from the 16 patients were reviewed. Of the 24 patients, 16 were immunocompromised, all with solid or hematological malignancy or a history of organ transplant. Twenty-four patients were identified for testing with the multiplex PCR assay. BAL specimens submitted to the microbiology laboratory were chosen based on as part of the internal validation of the panel in comparison with sputum culture at our hospitals. We compared the outcomes of the multiplex PCR assay with traditional culture methods and evaluated the role of PCR assay in de-escalating antimicrobial therapy. Among those patients undergoing bronchoscopy, those who were immunocompromised were selected for inclusion in the study. Patients hospitalized with pneumonia based on clinical and radiographic findings who underwent evaluation with bronchoscopy between May 2019 to January 2020 were reviewed. We compare BioFire® FilmArray® Pneumonia Panel (BioFire Diagnostics, Salt Lake City, Utah, United States), a multiplex polymerase chain reaction (PCR) assay, with standard of care diagnostics in BAL samples from immunocompromised patients to identify opportunities for this test to affect clinical decision making. In select patients, bronchoalveolar lavage (BAL) is performed to provide high-quality samples for analysis. ® is a registered trademark of the American Society for Clinical Laboratory Science.Immunocompromised patients, specifically those with solid organ transplants or cancer on chemotherapy, are at particularly high risk of severe pneumonia and opportunistic infections. BioFire Diagnostics is an approved provider of continuing education in the clinical laboratory sciences by the ASCLS P.A.C.E. ® credits are widely recognized in the clinical laboratory profession and can be used to fulfill most continuing education requirements. ![]() Impact of Rapid Molecular Diagnostics and Antimicrobial Stewardship in the Treatment of Bloodstream Infections by Russ Judd, PharmD, BCPS and Tristan Timbrook, PharmD, MBA, BCPS.Explore more AMR webinars from bioMérieux.Partnerships to Support Diagnostics in the Fight Against Antimicrobial Resistance by Dr.Learn More About Antimicrobial Resistance and Earn CE CreditsīioFire’s growing collection of online educational resources can help provide the tools and training you need to continue your success in the medical field.īoost your knowledge of antimicrobial resistance and syndromic infectious disease diagnostics with a variety of on-demand continuing education coursework-including CME courses developed by the Accreditation Council for Continuing Medical Education (ACCME)-and earn P.A.C.E. ![]()
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