FilmArray Respiratory Panel Assay: Comparison of Nasopharyngeal Swabs and Bronchoalveolar Lavage Samples
FilmArray Respiratory Panel Assay: Comparison of Nasopharyngeal Swabs and Bronchoalveolar Lavage Samples
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DOI：
10.1128/jcm.01516-15
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发表时间：
2015-12-01
影响因子：
9.4
通讯作者：
Grys, Thomas E.
中科院分区：
文献类型：
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作者：
Azadeh, Natalya;Sakata, Kenneth K.;Grys, Thomas E.
FilmArray呼吸面板（FARP）可靠、快速地识别出17种病毒和3种细菌病原体。对许多有呼吸道症状的患者进行鼻咽拭子FARP （NP FARP）。对于急性疾病或免疫功能受损或未能改善的患者，除NP FARP外，还进行支气管肺泡灌洗样本FARP （BAL FARP）。到目前为止，还没有研究将BAL FARP的产量与NP FARP的产量进行比较。我们回顾性研究了2013年6月至2014年5月期间所有在NP FARP术后7天内进行BAL FARP的患者。收集了人口统计学信息、合并症、FARP结果和BAL液的所有微生物学数据。86例患者在NP FARP后7天内进行了BAL FARP（平均1.6例，中位数1例）。其中66例（77%）具有一致的BAL和NP FARP结果，15例（23%）从NP和BAL FARP中鉴定出相同的病原体，51例（77%）具有一致的阴性FARP结果。86例患者中有18例（21%）从NP - FARP检测到病原体；其中，15例（83%）在随后的BAL FARP上匹配一致，其余3例BAL FARP阴性。86例患者中有17例（20%）从BAL farp中鉴定出了NP farp未检测到的病原体；其中，16例（94%）初始NP farp为阴性。这些数据表明，一旦通过NP FARP鉴定出病原体，随后的BAL FARP不太可能添加新的微生物学信息。然而，在NP FARP阴性后7天内进行BAL FARP可能提供新的、有用的微生物学信息。
The FilmArray respiratory panel (FARP) reliably and rapidly identifies 17 viruses and 3 bacterial pathogens. A nasopharyngeal swab FARP (NP FARP) is performed for many patients with respiratory symptoms. For patients who are acutely ill or immuno-compromised or fail to improve, a bronchoalveolar lavage sample FARP (BAL FARP) is performed in addition to the NP FARP. To date, no studies have compared the yield of a BAL FARP with that of an NP FARP. We retrospectively studied all patients who had a BAL FARP within 7 days after an NP FARP between June 2013 and May 2014. Demographic information, comorbidities, FARP results, and all microbiologic data from BAL fluid were collected. Eighty-six patients had a BAL FARP performed within 7 days (mean, 1.6; median, 1) after an NP FARP. Of these, 66 (77%) had concordant BAL and NP FARP results: 15 (23%) had the same pathogen identified from the NP and BAL FARPs, and 51 (77%) had concordant negative FARP results. In 18 of the 86 patients (21%), a pathogen was detected from the NP FARP; of these, 15 (83%) had a concordant match on a subsequent BAL FARP, and the remaining 3 had negative BAL FARPs. In 17 of the 86 patients (20%), pathogens were identified from the BAL FARPs that were not detected by the NP FARPs; of these, 16 (94%) had initial negative NP FARPs. The data suggest that once a pathogen is identified by an NP FARP, a subsequent BAL FARP is unlikely to add new microbiologic information. However, a BAL FARP may provide new, useful microbiologic information when performed within 7 days after a negative NP FARP.