BioFire® FilmArray® Pneumonia Panel versus bacterial culture in adult community acquired pneumonia: treatment implications

Abstract English: Background Severe community-acquired pneumonia (sCAP) is a growing burden on public health, associated with high morbidity and mortality. The diversity of aetiological agents requires that current guidelines consider the potential benefit of using rapid molecular techniques for microbial diagnosis as part of sCAP management. Objective This study aimed to assess the diagnostic performance of BioFire® FilmArray® Pneumonia Panel (BFPP) versus standard-of-care (SOC) culture for rapidly detecting respiratory pathogens and genetic markers among patients with sCAP. Methods The study was conducted on 236 patients with sCAP; lower respiratory tract (LRT) specimens were investigated by both BFPP and SOC, and the results were compared regarding the diagnostic performance, their related resistance genes and their effect on patient outcomes. Results BFPP showed an overall sensitivity of 81.97% (95% confidence interval [CI]: 73.98–88.34) and an overall specificity of 94.44% (95% CI: 93.59–95.21) over SOC. The 214 resistance genes detected by BFPP enabled rapid initiation of targeted antimicrobial therapy. Conclusion BFPP can enhance rapid microbiological diagnosis of patients with sCAP for early implementation of precision antimicrobial therapy, improving both morbidity and mortality. However, BFPP does not detect fungal pathogens, which is an important limitation in some clinical situations.