Enhanced Detection of Community-Acquired Pneumonia Pathogens With the BioFire® Pneumonia FilmArray® Panel.
Enhanced Detection of Community-Acquired Pneumonia Pathogens With the BioFire® Pneumonia FilmArray® Panel.
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利用BioFire®肺炎FilmArray®面板增强社区获得性肺炎病原体的检测
DOI：
10.1016/j.diagmicrobio.2020.115246
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发表时间：
2021-03
影响因子：
2.9
通讯作者：
Heffner J
中科院分区：
文献类型：
--
作者：
Gilbert DN;Leggett JE;Wang L;Ferdosian S;Gelfer GD;Johnston ML;Footer BW;Hendrickson KW;Park HS;White EE;Heffner J
尽管大多数观察性研究在50%或更少的社区获得性肺炎（CAP）住院患者中发现了病毒性或细菌性病原体，但我们之前证明了多重检测束（MTB）在73%的患者中发现了潜在病原体。本研究比较了MTB和Biofire®Pneumonia FilmArray®panel （BPFA）多重PCR平台对潜在病原体的检出率，并提出了一种整合BPFA结果的方法，作为后续抗生素管理（as）活动的基础。在2017年1月至2018年3月期间，纳入了所有接受CAP治疗的患者。如果完成了MTB和BPFA的所有要素，并且他们符合其他先验纳入标准，则认为患者是可评估的。主要终点是MTB（8个病毒靶点和6个细菌靶点）与BPFA（8个病毒靶点和18个细菌靶点）检测到的潜在病原体的百分比。所有患者均行血、痰培养。两个或两个以上的降钙素原（PCT）水平有助于临床评估是否检测到细菌入侵或定殖。在585例入组患者中，274例可评估。40.5%的MTB和60.9%的BPFA患者检测到潜在的病毒病原体，优势比（95% CI）为9.00 (4.12 ~ 23.30)p<0.01。66.4%的MTB与75.5%的BPFA比值比（95% CI）为2.09 (1.24 ~ 3.59),p 0.003)，鉴定出潜在的细菌病原体。低PCT水平有助于确定检测到的细菌是定植菌。
Although most observational studies identify viral or bacterial pathogens in 50% or less of patients hospitalized with community-acquired pneumonia (CAP), we previously demonstrated that a multi-test bundle (MTB) detected a potential pathogen in 73% of patients. This study compares detection rates for potential pathogens with the MTB versus the Biofire® Pneumonia FilmArray® panel (BPFA) multiplex PCR platform and presents an approach for integrating BPFA results as a foundation for subsequent antibiotic stewardship (AS) activities. Between January 2017 to March 2018, all patients admitted for CAP were enrolled. Patients were considered evaluable if all elements of the MTB and the BPFA were completed, and they met other a priori inclusion criteria. The primary endpoint was the percentage of potential pathogens detected using the MTB (8 viral and 6 bacterial targets) versus the BPFA (8 viral and 18 bacterial targets). Blood and sputum cultures were performed on all patients. Two or more procalcitonin (PCT) levels assisted clinical assessments as to whether detected bacteria were invading or colonizing. Of 585 enrolled patients, 274 were evaluable. A potential viral pathogen was detected in 40.5% with MTB versus 60.9% of patients with BPFA with an odds ratio (95% CI) of 9.00 (4.12 to 23.30) p<0.01. A potential bacterial pathogen was identified in 66.4% with the MTB vs 75.5% with the BPFA odds ratio (95% CI) of 2.09 (1.24 to 3.59), p 0.003). Low PCT levels helped identify detected bacteria as colonizers.
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DOI：
10.1016/j.diagmicrobio.2016.06.008
发表时间：
2016-09
影响因子：
2.9
作者：
Gilbert D;Gelfer G;Wang L;Myers J;Bajema K;Johnston M;Leggett J
通讯作者：
Leggett J
影响因子：
6.4
作者：
Gilbert, David N.
通讯作者：
Gilbert, David N.
影响因子：
3.7
作者：
Mewes, Janne C.;Pulia, Michael S.;Steuten, Lotte M.
通讯作者：
Steuten, Lotte M.
DOI：
10.1093/cid/cix317
发表时间：
2017-07-15
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Self WH;Balk RA;Grijalva CG;Williams DJ;Zhu Y;Anderson EJ;Waterer GW;Courtney DM;Bramley AM;Trabue C;Fakhran S;Blaschke AJ;Jain S;Edwards KM;Wunderink RG
通讯作者：
Wunderink RG
DOI：
10.1016/j.jinf.2013.03.003
发表时间：
2013-07
期刊：
The Journal of infection
影响因子：
--
作者：
Musher DM;Roig IL;Cazares G;Stager CE;Logan N;Safar H
通讯作者：
Safar H