Abstract Background: Lower respiratory tract infections (LRTIs) significantly contribute to global morbidity and mortality. Conventional bacterial LRTIs diagnosis relies on microbiological methods, which are time-consuming. The Biofire® FilmArray® Pneumonia Panel (FAPP) offers a faster and more accurate detection of respiratory pathogens but shows conflicting results with conventional cultures. Aim: We assessed the agreement between bacterial organisms and resistance genes identified using FAPP and standard culture techniques. Methods: This single-center retrospective study analyzed 400 patient samples, comparing the positive predictive value (PPV), negative predictive value (NPV), sensitivity, and specificity with conventional cultures. The prevalence of bacterial organisms and resistance markers in FAPP and cultures was estimated. Results: In 400 samples, 692 bacterial targets and 216 resistance markers were detected using FAPP. FAPP detection was 3.9 times higher than bacterial culture. The overall PPV, NPV, sensitivity, and specificity were 23.55%, 99.76%, 92.61%, and 90.92%, respectively. Multiple pathogens were found in 177 samples (46.3%) with FAPP. Conclusion: FAPP provides rapid and sensitive detection of respiratory bacterial infections. However, results should be interpreted with the clinical context. Further studies are needed to clarify its clinical impact and cost-effectiveness.
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