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Rapid syndromic PCR testing in patients with respiratory tract infections reduces time to results and improves microbial yield

Rapid syndromic PCR testing in patients with respiratory tract infections reduces time to results and improves microbial yield
Rapid syndromic PCR testing in patients with respiratory tract infections reduces time to results and improves microbial yield

Lack of rapid and comprehensive microbiological diagnosis in patients with community acquired pneumonia (CAP) hampers appropriate antimicrobial therapy. This study evaluates the real-world performance of the BioFire FilmArray Pneumonia panel plus (FAP plus) and explores the feasibility of evaluation in a randomised controlled trial. Patients presenting to hospital with suspected CAP were recruited in a prospective feasibility study. An induced sputum or an endotracheal aspirate was obtained from all participants. The FAP plus turnaround time (TAT) and microbiological yield were compared with standard diagnostic methods (SDs). 96/104 (92%) enrolled patients had a respiratory tract infection (RTI); 72 CAP and 24 other RTIs. Median TAT was shorter for the FAP plus, compared with in-house PCR (2.6 vs 24.1 h, p < 0.001) and sputum cultures (2.6 vs 57.5 h, p < 0.001). The total microbiological yield by the FAP plus was higher compared to SDs (91% (162/179) vs 55% (99/179), p < 0.0001). Haemophilus influenzae, Streptococcus pneumoniae and influenza A virus were the most frequent pathogens. In conclusion, molecular panel testing in adults with CAP was associated with a significant reduction in time to actionable results and increased microbiological yield. The impact on antibiotic use and patient outcome should be assessed in randomised controlled trials.

2045-2322
Clark, Tristan
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Serigstat, S
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Markussen, D
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Grewal, Harleen
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Ebbesen, M
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Kommedal, O
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Heggelund, L
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Werkhoven, CH van
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Faurholt-Jepsen, D
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Ritz, C
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Ulvestad, E
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Bjorneklett, R
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Knoop, ST
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Clark, Tristan
712ec18e-613c-45df-a013-c8a22834e14f
Serigstat, S
5f17825b-e5ed-4d0c-927d-8bbec27432e6
Markussen, D
92a537f7-ff48-41d1-9a3b-1515163245b7
Grewal, Harleen
2bb8b086-7fce-4fc0-9041-c2e8bf437749
Ebbesen, M
a48ccc36-de2b-470c-a5e2-992aa5bd22d1
Kommedal, O
76659442-c044-4fe2-8187-3b99813c5b2b
Heggelund, L
c486875d-ac33-4914-9671-590529c4d32b
Werkhoven, CH van
0ced94c1-4ac8-42e3-862c-1f1550031187
Faurholt-Jepsen, D
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Ritz, C
444d371d-fa08-4307-908f-d859f0503bc9
Ulvestad, E
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Bjorneklett, R
f1262a49-6d29-4d91-b5d9-5258adb811c0
Knoop, ST
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Clark, Tristan, Serigstat, S, Markussen, D, Grewal, Harleen, Ebbesen, M, Kommedal, O, Heggelund, L, Werkhoven, CH van, Faurholt-Jepsen, D, Ritz, C, Ulvestad, E, Bjorneklett, R and Knoop, ST (2022) Rapid syndromic PCR testing in patients with respiratory tract infections reduces time to results and improves microbial yield. Scientific Reports, 12 (326), [326]. (doi:10.1038/s41598-021-03741-7).

Record type: Article

Abstract

Lack of rapid and comprehensive microbiological diagnosis in patients with community acquired pneumonia (CAP) hampers appropriate antimicrobial therapy. This study evaluates the real-world performance of the BioFire FilmArray Pneumonia panel plus (FAP plus) and explores the feasibility of evaluation in a randomised controlled trial. Patients presenting to hospital with suspected CAP were recruited in a prospective feasibility study. An induced sputum or an endotracheal aspirate was obtained from all participants. The FAP plus turnaround time (TAT) and microbiological yield were compared with standard diagnostic methods (SDs). 96/104 (92%) enrolled patients had a respiratory tract infection (RTI); 72 CAP and 24 other RTIs. Median TAT was shorter for the FAP plus, compared with in-house PCR (2.6 vs 24.1 h, p < 0.001) and sputum cultures (2.6 vs 57.5 h, p < 0.001). The total microbiological yield by the FAP plus was higher compared to SDs (91% (162/179) vs 55% (99/179), p < 0.0001). Haemophilus influenzae, Streptococcus pneumoniae and influenza A virus were the most frequent pathogens. In conclusion, molecular panel testing in adults with CAP was associated with a significant reduction in time to actionable results and increased microbiological yield. The impact on antibiotic use and patient outcome should be assessed in randomised controlled trials.

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Accepted/In Press date: 10 January 2022
Published date: 10 January 2022
Additional Information: Funding Information: C. H. van Werkhoven has received non-financial and financial research support from BioMérieux. Tristan W. Clark has received consulting fees, honoraria for lectures and manuscript writing/educational events, support for attending meetings and other services from BioMérieux and BioFire LLC. The other authors have nothing to disclose. Funding Information: This work was supported by the Trond Mohn Foundation (RESPNOR; BFS2019TMT06), The Research Council of Norway (NORCAP; 288718), The University of Bergen and Haukeland University Hospital. Publisher Copyright: © 2022, The Author(s).

Identifiers

Local EPrints ID: 454441
URI: http://eprints.soton.ac.uk/id/eprint/454441
ISSN: 2045-2322
PURE UUID: f8f1c698-e65d-420e-8a11-3dfb6806360b
ORCID for Tristan Clark: ORCID iD orcid.org/0000-0001-6026-5295

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Date deposited: 09 Feb 2022 17:41
Last modified: 02 Dec 2022 02:46

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Contributors

Author: Tristan Clark ORCID iD
Author: S Serigstat
Author: D Markussen
Author: Harleen Grewal
Author: M Ebbesen
Author: O Kommedal
Author: L Heggelund
Author: CH van Werkhoven
Author: D Faurholt-Jepsen
Author: C Ritz
Author: E Ulvestad
Author: R Bjorneklett
Author: ST Knoop

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