Multiplex Tests for Respiratory Tract Infections: The Direct Utility of the FilmArray Respiratory Panel in Emergency Department

Overview

Journal Can Respir J

Publisher Wiley

Specialty Pulmonary Medicine

Date 2020 Aug 11

PMID 32774562

Citations 8

Authors

Siyuan Yang

Hui Li

Yunxia Tang

Fengting Yu

Chengjie Ma

Huimin Zhang

Lin Pang

Hongxin Zhao

Linghang Wang

Affiliations

Soon will be listed here.

Abstract

Background: The FilmArray Respiratory Panel with multiplex targets for respiratory pathogens has been widely used and verified in clinical trials in special test settings. However, it is necessary to evaluate the panel's performance at the point of care directly, in nonspecific test settings.

Methods: Patients with respiratory tract infections were enrolled from among emergency department visitors, and all steps, including the collection of specimens and testing, were performed by our clinicians.

Results: Among 270 patients, 196 (72.6%) patients were found to have one or more pathogens. For signal pathogen detection, influenza A virus had the highest rate of detection; 45 (16.7%) of the patients had two or more respiratory pathogens codetected, and most of the multiplex pathogens were rhinovirus/enterovirus codetected with (17.8%). The information provided by the FilmArray had an impact on the prescription of antimicrobials, and there were differences in the rates of antibiotic prescriptions and anti-influenza prescriptions among patients.

Conclusions: Use of the FilmArray by clinical staff was successfully implemented in the emergency department for the first time in China. The FilmArray has the potential for point-of-care testing in nonspecific settings.

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References

Wabe N, Li L, Dahm M, Lindeman R, Yimsung R, Clezy K . Timing of respiratory virus molecular testing in emergency departments and its association with patient care outcomes: a retrospective observational study across six Australian hospitals. BMJ Open. 2019; 9(8):e030104. PMC: 6701571. DOI: 10.1136/bmjopen-2019-030104. View

Ding G, Vinturache A, Lu M . Addressing inappropriate antibiotic prescribing in China. CMAJ. 2019; 191(6):E149-E150. PMC: 6370538. DOI: 10.1503/cmaj.181417. View

Liu Y, Gao Y, Chen M, Cao B, Yang X, Wei L . Etiological analysis and predictive diagnostic model building of community-acquired pneumonia in adult outpatients in Beijing, China. BMC Infect Dis. 2013; 13:309. PMC: 3728139. DOI: 10.1186/1471-2334-13-309. View

McAllister D, Liu L, Shi T, Chu Y, Reed C, Burrows J . Global, regional, and national estimates of pneumonia morbidity and mortality in children younger than 5 years between 2000 and 2015: a systematic analysis. Lancet Glob Health. 2018; 7(1):e47-e57. PMC: 6293057. DOI: 10.1016/S2214-109X(18)30408-X. View

Litwin C, Bosley J . Seasonality and prevalence of respiratory pathogens detected by multiplex PCR at a tertiary care medical center. Arch Virol. 2013; 159(1):65-72. PMC: 7086932. DOI: 10.1007/s00705-013-1794-4. View

Nair H, Simoes E, Rudan I, Gessner B, Azziz-Baumgartner E, Zhang J . Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis. Lancet. 2013; 381(9875):1380-1390. PMC: 3986472. DOI: 10.1016/S0140-6736(12)61901-1. View

Chen L, Zhou F, Li H, Xing X, Han X, Wang Y . Disease characteristics and management of hospitalised adolescents and adults with community-acquired pneumonia in China: a retrospective multicentre survey. BMJ Open. 2018; 8(2):e018709. PMC: 5829872. DOI: 10.1136/bmjopen-2017-018709. View

Busson L, Bartiaux M, Brahim S, Konopnicki D, Dauby N, Gerard M . Contribution of the FilmArray Respiratory Panel in the management of adult and pediatric patients attending the emergency room during 2015-2016 influenza epidemics: An interventional study. Int J Infect Dis. 2019; 83:32-39. PMC: 7110685. DOI: 10.1016/j.ijid.2019.03.027. View

Leber A, Everhart K, Daly J, Hopper A, Harrington A, Schreckenberger P . Multicenter Evaluation of BioFire FilmArray Respiratory Panel 2 for Detection of Viruses and Bacteria in Nasopharyngeal Swab Samples. J Clin Microbiol. 2018; 56(6). PMC: 5971546. DOI: 10.1128/JCM.01945-17. View

10.

Qu J, Yang C, Bao F, Chen S, Gu L, Cao B . Epidemiological characterization of respiratory tract infections caused by Mycoplasma pneumoniae during epidemic and post-epidemic periods in North China, from 2011 to 2016. BMC Infect Dis. 2018; 18(1):335. PMC: 6050680. DOI: 10.1186/s12879-018-3250-2. View

11.

Childs A, Zullo A, Joyce N, McConeghy K, van Aalst R, Moyo P . The burden of respiratory infections among older adults in long-term care: a systematic review. BMC Geriatr. 2019; 19(1):210. PMC: 6683564. DOI: 10.1186/s12877-019-1236-6. View

12.

Brendish N, Malachira A, Armstrong L, Houghton R, Aitken S, Nyimbili E . Routine molecular point-of-care testing for respiratory viruses in adults presenting to hospital with acute respiratory illness (ResPOC): a pragmatic, open-label, randomised controlled trial. Lancet Respir Med. 2017; 5(5):401-411. PMC: 7164815. DOI: 10.1016/S2213-2600(17)30120-0. View

13.

Xu M, Qin X, Astion M, Rutledge J, Simpson J, Jerome K . Implementation of filmarray respiratory viral panel in a core laboratory improves testing turnaround time and patient care. Am J Clin Pathol. 2012; 139(1):118-23. PMC: 7110182. DOI: 10.1309/AJCPH7X3NLYZPHBW. View

14.

Self W, Williams D, Zhu Y, Ampofo K, Pavia A, Chappell J . Respiratory Viral Detection in Children and Adults: Comparing Asymptomatic Controls and Patients With Community-Acquired Pneumonia. J Infect Dis. 2015; 213(4):584-91. PMC: 4721902. DOI: 10.1093/infdis/jiv323. View

15.

Ma X, Conrad T, Alchikh M, Reiche J, Schweiger B, Rath B . Can we distinguish respiratory viral infections based on clinical features? A prospective pediatric cohort compared to systematic literature review. Rev Med Virol. 2018; 28(5):e1997. PMC: 7169127. DOI: 10.1002/rmv.1997. View

16.

Xu Y, Wang L, Xu J, Wang X, Wei C, Luo P . Seroprevalence of pertussis in China: need to improve vaccination strategies. Hum Vaccin Immunother. 2013; 10(1):192-8. PMC: 4181022. DOI: 10.4161/hv.26335. View

17.

. Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study. Lancet. 2019; 394(10200):757-779. PMC: 6727070. DOI: 10.1016/S0140-6736(19)30721-4. View

18.

Rappo U, Schuetz A, Jenkins S, Calfee D, Walsh T, Wells M . Impact of Early Detection of Respiratory Viruses by Multiplex PCR Assay on Clinical Outcomes in Adult Patients. J Clin Microbiol. 2016; 54(8):2096-103. PMC: 4963510. DOI: 10.1128/JCM.00549-16. View

19.

Shengchen D, Gu X, Fan G, Sun R, Wang Y, Yu D . Evaluation of a molecular point-of-care testing for viral and atypical pathogens on intravenous antibiotic duration in hospitalized adults with lower respiratory tract infection: a randomized clinical trial. Clin Microbiol Infect. 2019; 25(11):1415-1421. PMC: 7173318. DOI: 10.1016/j.cmi.2019.06.012. View

20.

Zhao M, Li G, Zhang D, Zhou H, Wang H, Yang S . Clinical evaluation of a new single-tube multiplex reverse transcription PCR assay for simultaneous detection of 11 respiratory viruses, Mycoplasma pneumoniae and Chlamydia in hospitalized children with acute respiratory infections. Diagn Microbiol Infect Dis. 2017; 88(2):115-119. PMC: 7132751. DOI: 10.1016/j.diagmicrobio.2017.03.010. View