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. 2024 Jan 12;229(1):214-222.
doi: 10.1093/infdis/jiad221.

Real-life Assessment of BioFire FilmArray Pneumonia Panel in Adults Hospitalized With Respiratory Illness

Ann R Falsey  1 , Angela R Branche  1 , Daniel P Croft  2 , Maria A Formica  3 , Michael R Peasley  1 , Edward E Walsh  1
Affiliations

Real-life Assessment of BioFire FilmArray Pneumonia Panel in Adults Hospitalized With Respiratory Illness

Ann R Falsey et al. J Infect Dis. .

Abstract

Background: Inability to identify the microbial etiology of lower respiratory tract infection leads to unnecessary antibiotic use. We evaluated the utility of the BioFire FilmArray Pneumonia Panel (BioFire PN) to inform microbiologic diagnosis.

Methods: Hospitalized adults with respiratory illness were recruited; sputa and clinical/laboratory data were collected. Sputa were cultured for bacteria and tested with BioFire PN. Microbial etiology was adjudicated by 4 physicians. Bacterial polymerase chain reaction (PCR) was compared with culture and clinical adjudication.

Results: Of 298 sputa tested, BioFire PN detected significantly more pathogens (350 bacteria, 16 atypicals, and 164 viruses) than sputum culture plus any standard-of-care testing (91% vs 60%, P < .0001). When compared with culture, the sensitivity of BioFire PN for individual bacteria was 46% to 100%; specificity, 61% to 100%; and negative predictive value, 92% to 100%. Cases were adjudicated as viral (n = 58) and bacterial (n = 100). PCR detected bacteria in 55% of viral cases and 95% of bacterial (P < .0001). High serum procalcitonin and bacterial adjudication were more often associated with sputa with 106 or 107 copies detected.

Conclusions: Multiplex PCR testing of sputa for bacteria is useful to rule out bacterial infection with added value to detect viruses and atypical bacteria.

Keywords: bacteria; diagnostic; respiratory illness; sputum; viruses.

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Conflict of interest statement

Potential conflicts of interest . None of the authors have any financial conflicts with the data presented in this article. A. R. F. receives research funding from Janssen, Merck, Pfizer, CyanVac, Vaccine Company, and BioFire Diagnostics; consulting fees from Sanofi Pasteur and Arrow Pharmaceuticals; and fees for DMSB service for Novavax. A. R. B. receives research funding from Merck, Pfizer, CyanVac, and Vaccine Company and consulting fees from Jansen and GSK. E. E. W. receives research funding from Merck, Vaccine Company, and Pfizer and consulting fees for Merck. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Mean semiquantitative levels of bacteria in all 298 sputum samples tested by BioFire FilmArray Pneumonia Panel. Samples include sputa with good or moderate quality. Semiquantitative results are expressed a genomic copy per milliliter log10. Mean quantity was compared for S pneumoniae, H influenzae, M catarrhalis, P aeruginosa, group A streptococcus (GAS), S aureus, group B streptococcus (GBS), and other Gram-negative rods (GNR). For each comparison, values were significantly higher for S pneumoniae, H influenzae, M catarrhalis, and Pseudomonas aeruginosa vs S aureus, GBS, and other GNR. P < .003 for all comparisons.
Figure 2.
Figure 2.
Diagnostic yield of BioFire FilmArray Pneumonia Panel (BioFire PN) vs any standard-of-care (SOC) test. A, Potential pathogens detected in 298 sputum samples of good and moderate quality by BioFire PN divided into microbiologic categories. Categories: bacteria alone, bacteria + virus, bacteria + atypical bacteria, virus alone, virus + atypical bacteria, atypical bacteria alone, no pathogen. B, Total microbiologic pathogens detected by any SOC test. Results include the sum of positive results from 126 sputum cultures, 5 blood cultures, and 19 urine antigen tests.
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