Rapid diagnostic tests are tools of paramount impact both for improving patient care and in antimicrobial management programs. Particularly in the case of respiratory infections, it is of great importance to quickly confirm/exclude the involvement of pathogens, be they bacteria or viruses, while obtaining information about the presence/absence of a genetic target of resistance to modulate antibiotic therapy. In this paper, we present our experiences with the use of the Biofire® FilmArray® Pneumonia Panel Plus (FAPP; bioMérieux; Marcy l’Etoile, France) to assess coinfection in COVID-19 patients. A total of 152 respiratory samples from consecutive patients were examined, and 93 (61%) were found to be FAPP positive, with the detection of bacteria and/or viruses. The patients were 93 males and 59 females with an average age of 65 years who were admitted to our hospital due to moderate/severe acute respiratory symptoms. Among the positive samples were 52 from sputum (SPU) and 41 from bronchoalveolar lavage (BAL). The most representative species was S. aureus (most isolates were mec A positive; 30/44, 62%), followed by gram-negative pathogens such as P. aeruginosa , K. pneumoniae , and A. baumannii . Evidence of a virus was rare. Cultures performed from BAL and SPU samples gave poor results. Most of the discrepant negative cultures were those in which FAPP detected pathogens with a microbial count ≤ 10 5 CFU/mL. H. influenzae was one of the most common pathogens lost by the conventional method. Despite the potential limitations of FAPP, which detects a defined number of pathogens, its advantages of rapid detection combined with predictive information regarding the antimicrobial resistance of pathogens through the detection of some relevant markers of resistance could be very useful for establishing empirical targeted therapy for the treatment of patients with respiratory failure. In the COVID era, we understand the importance of using antibiotics wisely to curb the phenomenon of antibiotic resistance.
【저자키워드】 Molecular medicine, clinical microbiology, 【초록키워드】 Treatment, viruses, respiratory infections, Respiratory failure, Pneumonia, hospital, diagnostic test, Genetic, Antibiotics, sputum, virus, antimicrobial resistance, COVID, BAL, Coinfection, Culture, pathogen, diagnostic tests, management, male, female, Patient, Rapid, France, age, Pathogens, Bacteria, respiratory, targeted therapy, information, Respiratory samples, COVID-19 patients, marker, Bronchoalveolar lavage, Antibiotic resistance, bioMérieux, microbial, evidence of, followed by, average age, Predictive, Patient care, Antibiotic therapy, consecutive patients, phenomenon, average, cultures, pneumoniae, positive, H. influenzae, P. aeruginosa, potential limitations, MOST, positive sample, acute respiratory symptoms, isolate, respiratory sample, defined, performed, detect, examined, modulate, consecutive patient, obtaining information, Panel, potential limitation, 【제목키워드】 Rapid diagnostic test, SARS-CoV-2 positive patient,