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. 2021 Jul:186:106259.
doi: 10.1016/j.mimet.2021.106259. Epub 2021 May 29.

Respiratory bacterial co-infections in intensive care unit-hospitalized COVID-19 patients: Conventional culture vs BioFire FilmArray pneumonia Plus panel

Claudio Foschi  1 , Anna Zignoli  2 , Paolo Gaibani  3 , Caterina Vocale  3 , Giada Rossini  3 , Silvia Lafratta  2 , Andrea Liberatore  2 , Gabriele Turello  2 , Tiziana Lazzarotto  4 , Simone Ambretti  3
Affiliations

Respiratory bacterial co-infections in intensive care unit-hospitalized COVID-19 patients: Conventional culture vs BioFire FilmArray pneumonia Plus panel

Claudio Foschi et al. J Microbiol Methods. 2021 Jul.

Abstract

The prevalence and microbiology of concomitant respiratory bacterial infections in patients with SARS-CoV-2 infection are not yet fully understood. In this retrospective study, we assessed respiratory bacterial co-infections in lower respiratory tract samples taken from intensive care unit-hospitalized COVID-19 patients, by comparing the conventional culture approach to an innovative molecular diagnostic technology. A total of 230 lower respiratory tract samples (i.e., bronchial aspirates or bronchoalveolar lavages) were taken from 178 critically ill COVID-19 patients. Each sample was processed by a semi-quantitative culture and by a multiplex PCR panel (FilmArray Pneumonia Plus panel), allowing rapid detection of a wide range of clinically relevant pathogens and a limited number of antimicrobial resistance markers. More than 30% of samples showed a positive bacterial culture, with Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus the most detected pathogens. FilmArray showed an overall sensitivity and specificity of 89.6% and 98.3%, respectively, with a negative predictive value of 99.7%. The molecular test significantly reduced the turn-around-time (TAT) and increased the rates of microbial detection. Most cases missed by culture were characterized by low bacterial loads (104-105 copies/mL). FilmArray missed a list of pathogens not included in the molecular panel, especially Stenotrophomonas maltophilia (8 cases). FilmArray can be useful to detect bacterial pathogens in lower respiratory tract specimens of COVID-19 patients, with a significant decrease of TAT. The test is particularly useful to rule out bacterial co-infections and avoid the inappropriate prescription of antibiotics.

Keywords: COVID-19; Coinfections; FilmArray; Respiratory infections; SARS-CoV-2.

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Conflict of interest statement

This study was conducted in the absence of any commercial or financial relationships that could be construed as potential conflict of interest. All the authors declare the absence of any dual or conflicting interest.

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