Modernising respiratory diagnostics: the impact of biofire FilmArray pneumonia panel plus and respiratory panel on the detection of viruses and atypical bacteria

Abstract

BACKGROUND The incidence of pneumonia is high within our local patient population and it is a significant cause of morbidity and mortality. The adoption of rapid molecular technology enables targeted clinical interventions and the initiation of appropriate antimicrobial and antiviral therapy. METHOD From February 2019, all lower respiratory samples submitted for microbiological analysis were examined to assess if a Pneumonia FilmArray would be a suitable investigation; indications for testing included radiological evidence of pneumonia or relevant clinical information suggesting atypical infection. Nasal pharyngeal swabs could be requested by clinicians across the hospital based on presenting signs and symptoms. RESULTS In total 883 nasal pharyngeal swabs and 175 lower respiratory tract samples from 927 patients were tested, 514 positive results were obtained; 450 from nasal pharyngeal swabs and 64 from lower respiratory tract samples. Notably, two Bordetella pertussis and two Legionella pneumophiliaand five Mycoplasma pneumoniae were detected. One of the Bordetella pertussis was confirmed by culture, 9 days after the molecular result and the other case was detected in a neutropenic adult within an oncology, enabling rapif infection control intervention. Both Legionella cases were confirmed with urinary antigen testing, however neither grew on culture. CONCLUSION FilmArray technology enables the rapid identification of the causative agents of viral and atypical pneumonia, it is a useful adjunct to traditional testing and it enables rapid clinical and infection control intervention.