Evaluation of FilmArray respiratory panel for the rapid and multi-pathogen detection in children with severe pneumonia

Abstract

Objective To evaluate the value of nested polymerase chain reaction (PCR) for the rapid detection of pathogens in children with severe pneumonia. Methods We prospectively enrolled the patients with severe community-acquired pneumonia admitted to pediatric intensive care unit (PICU) in Shanghai Children′s Hospital from January 2017 to June 2018.The sputum for PCR were collected within 24 h after PICU admission.Both nested PCR and routine microbiological methods were performed.Respiratory Panel (R-Panel) based on nested PCR could detect 17 kinds of respiratory pathogen at the same time. Results A total of 65 patients were enrolled in this study and the samples were detected using both R-Panel and routine microbiological method.(1) A total of 15 patients (23.08 %) showed positive routine microbiological detection including 13 cases with virus-positive and 2 cases with mycoplasma-positive; (2) A total of 38 patients (58.46%) showed positive results using R-Panel within 2 h including 46 cases with virus-positive and 5 cases with mycoplasma-positive.The mainly primary infection was human rhinovirus and enterovirus in 15 cases (23.08%), followed by adenovirus in 10 cases (15.38%); and the positive rate of 2 or more pathogens was 18.46% (12/65); (3) The rate of adenovirus-positive using R-Panel was significantly higher than that using routine microbiological methods (15.38 % vs.4.62%, χ2=4.188, P=0.041); the sensitivity of R-Panel for detection of adenovirus, respiratory syncytial virus, and parainfluenza virus was significantly higher than those of routine microbiological methods (100% vs.30%, χ2=107.692; 50.00% vs.16.67%, χ2=24.442; 100% vs.80%, χ2=22.222; 100% vs.40%, χ2=85.714; all P<0.001). Conclusion R-Panel using nested PCR is a rapid, sensitive, and specific method for the detection of pathogens in children with severe community acquired pneumonia, which is valuable for targeted therapy in time. Key words: Severe pneumonia; Respiratory panel (R-Panel); Multiplex polymerase chain reaction; Critically ill; Children