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Clin Microbiol Infect. 2018 Nov;24(11):1213.e1-1213.e4. doi: 10.1016/j.cmi.2018.06.001. Epub 2018 Jun 12.

Application of BioFire FilmArray Blood Culture Identification panel for rapid identification of the causative agents of ventilator-associated pneumonia.

Author information

1
Clinical Unit of Infectious Diseases, Clinical Microbiology and Preventive Medicine, Seville, Spain.
2
Infectious Diseases and Clinical Microbiology Unit, Seville, Spain.
3
Department of Critical Care Medicine, University Hospitals Virgen del Rocío y Macarena/CSIC/Universidad de Sevilla, Seville, Spain.
4
Department of Anaesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy.
5
Department of Critical Care Medicine, Attikon University Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
6
Clinical Unit of Infectious Diseases, Clinical Microbiology and Preventive Medicine, Seville, Spain. Electronic address: mcconnell.mike75@gmail.com.
7
Hospital Universitario La Fe de Valencia, Valencia, Spain.
8
Hospital 12 de Octubre, Madrid, Spain.
9
Hospital General de Ciudad Real, Real, Spain.
10
Hospital de Jerez, Cádiz, Spain.
11
Hospital Peset, Valencia, Spain.
12
Hospital Universitario Puerta del Mar, Cádiz, Spain.
13
Hospital Universitario Carlos Haya, Málaga, Spain.
14
Complejo Hospitalario A Coruña, A Coruña, Spain.
15
Hospital Clinico San Carlos, Madrid, Spain.
16
Hospital General Universitario Santa Lucia, Cartagena, Spain.
17
Hospital Universitario Marqués de Valdecilla, Santander, Spain.
18
Hospital Virgen de la Victoria, Málaga, Spain.
19
Hospital Mutua de Terrassa, Barcelona, Spain.
20
Complexo Hospitalario Universitario de Ourense, Orense, Spain.
21
University Hospital Attikon, Athens, Greece.
22
Nanas Evangelismos Hospital, Athens, Greece.
23
University Hospital of Heraklion, Crete, Greece.
24
University Hospital of Alexandroupolis, Thrace, Greece.
25
University Hospital of Ioannina, Medical School, Ipirus, Greece.
26
University Hospital Ag Anargiri, Athens, Greece.
27
Sotiria Hospital, Athens, Greece.
28
University Hospital of Larissa, Athens, Greece.
29
Papanikolaou Hospital, Thessaloniki, Greece.
30
General Hospital of Larissa, Athens, Greece.
31
Policlinico Universitario A Gemelli, Rome, Italy.
32
Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy.
33
Policlinico Umberto I Università La Sapienza, Rome, Italy.
34
Azienda Ospedaliera Sant'Andrea, Rome, Italy.
35
AO Ospedale Niguarda Ca Granda, Milano, Italy.
36
S Giovanni B Molinette Hospital, Turin, Italy.
37
University of Napoli Federico II, Napoli, Italy.
38
AOU Cisanello, Pisa, Italy.

Abstract

OBJECTIVE:

To evaluate the ability of the BioFire FilmArray Blood Culture Identification (BCID) panel to rapidly detect pathogens producing late-onset ventilator-associated pneumonia (VAP), a severe infection often produced by Gram-negative bacteria. These microorganisms are frequently multidrug resistant and typically require broad-spectrum empiric treatment.

METHODS:

In the context of an international multicentre clinical trial (MagicBullet), respiratory samples were collected at the time of suspicion of VAP from 165 patients in 32 participating hospitals in Spain, Greece and Italy. Microorganisms were identified using the BCID panel and compared with results obtained by conventional microbiologic techniques.

RESULTS:

Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae were the most commonly identified species, representing 54.7% (70/128) of microorganisms. The BCID panel showed high global specificity (98.1%; 95% confidence interval, 96-100) and negative predictive values (96.6%) and a global sensitivity and positive predictive value of 78.6% (95% confidence interval, 70-88) and 87.3%, respectively, for these microorganisms. Importantly, the BCID panel provided results in only 1 hour directly from respiratory samples with minimal sample processing times.

CONCLUSIONS:

The BCID panel may have clinical utility in rapidly ruling out microorganisms causing VAP, specifically multidrug-resistant Gram-negative species. This could facilitate the optimization of empiric treatment.

KEYWORDS:

Antibiotic resistance; FilmArray BCID panel; Gram-negative bacteria; Rapid diagnosis; Ventilator-associated pneumonia

PMID:
29906599
DOI:
10.1016/j.cmi.2018.06.001
[Indexed for MEDLINE]

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