Application of FilmArray detction in severe pneumonia in children

Abstract

Objective To explore the application value of the FilmArray detection system in the diagnosis and treatment of severe pneumonia in children, and to understand the pathogenic characteristics of severe pneumonia in children. Methods A tolal of 158 nasopharyngeal swab specimens were collected from children with severe pneumonia in Hunan Children's Hospital from May 2017 to March 2018. FilmArray were used to detect respiratory pathogen. Blood routine, C-reactive protein (CRP), procalcitonin (PCT) and seven kinds of respiratory virus antigen were also performed on all the samples. The pathogenic characteristics of 158 cases of severe pneumonia were analyzed, and the positive rate of seven kinds of respiratory virus antigen test method and FilmArray were statistically analyzed. Results Among 158 patients with severe pneumonia, 114(72.15%) were positive and 91(57.59%) single pathogen infection were detected by FilmArray, with the highest detection rate of rhinoviruses/enteroviruses (16.46%). 23(14.56%) mixed infection were detected by FilmArray, respiratory syncytial virus combined with adenovirus infection had the highest positive rate (2.53%). The detection of respiratory pathogens in different age groups was analyzed. The highest positivity rates of children aged 1-3 years was human rhinovirus/enterovirus (25%), 3-5 years were influenza virus A and adenovirus (27.27%), >5 years was human rhinovirus/enterovirus (26.08%). Among 158 patients, 53(33.54%) had bacterial infection, and the most common bacterial infection was Streptococcus pneumoniae (7.59%). In seven respiratory virus antigen test negetive children, PCT in Film Array negative group was higher than that in Film Array positive group (P=0.03). The positive rate of FilmArray was higher than that of the seven respiratory virus antigen test method (72.15% vs 19.62%, P<0.01). The level of white blood cell and cough days in pertussis group were higher than that in non-pertussis group, which was significantly different (P<0.01). The PCT level in non-pertussis group was higher than that in pertussis group, with significant difference (P<0.01). Conclusions FilmArray detection can detect 20 kinds of respiratory tract pathogens rapidly and accurately. The positive rate of detection is high, and the diagnosis rate of virus is improved. The combination of infection indicators and sputum culture results by clinicians can better guide the clinical diagnosis and treatment. Key words: Pneumonia; Intensive care units, pediatric; Microbial sensitivity tests