Rapid detection of respiratory organisms with FilmArray respiratory panel and its impact on clinical decisions in Shanghai, China, 2016-2018

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Influenza Other Respir Viruses. 2019 Dec 1. doi: 10.1111/irv.12701. [Epub ahead of print] Rapid detection of respiratory organisms with FilmArray respiratory panel and its impact on clinical decisions in Shanghai, China, 2016-2018.

Qian Y¹, Ai J¹, Wu J¹, Yu S¹, Cui P¹, Gao Y¹, Jin J¹, Weng X¹, Zhang W^1,2,3,4.
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1 Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China. 2 State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai, China. 3 National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China. 4 Key Laboratory of Medical Molecular Virology (MOE/MOH) and Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University, Shanghai, China.

Abstract

BACKGROUND:

In this study, we evaluated the diagnostic potential and clinical impact of an automated multiplex PCR platform (the FilmArray Respiratory Panel; FA-RP), specially designed for pathogen detection in respiratory tract infections in adults with unexplained pneumonia (UP).
METHODS:

A total of 112 UP patients in Shanghai, China, were enrolled prospectively and assessed using the FA-RP from October 2016 to March 2018. We examined the test results and their influence on clinical decisions. Furthermore, as a control group, we retrospectively obtained the clinical data of 70 UP patients between October 2014 and March 2016 (before the FA-RP was available). The two patient groups were compared with respect to factors, including general antimicrobial use and defined daily dose (DDD) numbers.
RESULTS:

Between October 2016 and March 2018, the positive rate obtained using FA-RP for UP was 76.8%. The primary pathogens in adults with UP were Influenza A/B (47.3%, 53/112). Compared with the patients before FA-RP was available, patients who underwent FA-RP testing had higher rates of antiviral drug use and antibiotic de-escalation during clinical treatment. FA-RP significantly decreased the total DDDs of antibiotic or antifungal drugs DDDs by 7 days after admission (10.6 ? 2.5 vs 14.1 ? 8.8, P < .01).
CONCLUSIONS:

The FA-RP is a rapid and sensitive nucleic acid amplification test method for UP diagnosis in adults. The application of FA-RP may lead to a more accurately targeted antimicrobial treatment and reduced use of antibiotic/antifungal drugs.
? 2019 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.


KEYWORDS:

FilmArray respiratory panel; antibiotic use; clinical decision; respiratory virus; unexplained pneumonia

PMID: 31786832 DOI: 10.1111/irv.12701
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