Five years-real-world experience with FilmArray Pneumonia Plus Panel in the diagnosis of pneumonia in an intensive care unit in a tertiary hospital: Lights and shadows in pandemic and postpandemic COVID periods

Abstract

Introduction

The main objective of the study is to evaluate the performance of the FilmArray® Pneumonia Plus (FA-PP) panel in critically ill patients with suspected pneumonia compared to conventional culture, in both pandemic and pospandemic periods, and its impact on therapeutic decision-making.

Methods

Observational study including 225 patients (314 samples) during COVID-19 pandemic and post-pandemic periods. FA-PP and culture results were compared assessing sensitivity (Se), specificity, predictive values, level of concordance between them and the impact on antibiotic prescription.

Results

FA-PP detected 133% more bacterial targets than culture and 48% more positive samples. Excluding off-panel bacteria, the panel showed high sensitivity of up to 100% in patients with pneumonia and a negative predictive value (NPV) of over 98%. In the post-pandemic period, the overall Se (78.6%) and Se in patients with pneumonia (81%), as well as the overall NPV and in pneumonia (94%), were higher than in the pandemic period, with significant differences (p < 0.05). Twenty-six per cent of pneumonia episodes involved bacteria not included in the panel. The positive concordance between the two tests was 72%. In 56% of cases with pneumonia, antibiotic was modified after the results. During the pandemic period, the panel served to modify treatment towards initiation or escalation.

Conclusions

The FA-PP is a valuable tool for optimizing the diagnosis and management of pneumonia in the ICU, with a clinical impact on the appropriateness of antibiotic treatment. There were differences in the impact of the panel between the pandemic and post-pandemic periods.