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

摘要

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.