International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Clinical significance of negative BioFire® pneumonia panel in ICU: Diagnosis, management, and outcomes.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Nardy Thibault, Rondinaud Emilie, Dessajan Julien, Lo Stéphane, Bouadma Lila, Sonneville Romain, de Montmollin Etienne, Atchade Enora, Armand-Lefèvre Laurence, Timsit Jean-Francois, Thy Michael
Аннотация
OBJECTIVES: This study assessed the clinical significance of negative BioFire® FilmArray® Pneumonia Panel (FA-PP) results in ICU patients with suspected hospital-acquired (HAP) or ventilator-associated pneumonia (VAP), evaluating its impact on diagnosis, antimicrobial management, and outcomes, and identifying factors associated with false-negative results.
METHODS: A retrospective single-center study (April 2021 to July 2023) included 190 critically ill patients with negative FA-PP results on deep respiratory samples. Patients with microbiologically confirmed HAP/VAP were compared to those without.
RESULTS: Among 190 patients, 69 (36%) had culture-confirmed HAP/VAP. Gram-negative bacilli (GNB) on Gram stain independently predicted true infection (OR = 3.08, 95% CI [1.47-6.45], P = 0.003). The false-negative rate for FA-PP-detectable bacteria was 12% (31/251), mainly Klebsiella pneumoniae and Pseudomonas aeruginosa. Nontargeted GNBs accounted for 27% (19/69) of confirmed cases. Recent broad-spectrum antibiotic exposure (≤3 months) reduced confirmed infection likelihood (OR = 0.28, 95% CI [0.13-0.6], P < 0.001). No inappropriate antibiotic de-escalation occurred, but 6% (7/121) of noninfected patients had antibiotics withdrawn based solely on FA-PP negativity.
CONCLUSIONS: Negative FA-PP results do not exclude HAP/VAP, especially with nontargeted GNBs or recent antibiotic exposure. Gram stain remains a valuable complementary tool. Integrated diagnostic approaches are essential for optimal antimicrobial stewardship in ICU settings.
METHODS: A retrospective single-center study (April 2021 to July 2023) included 190 critically ill patients with negative FA-PP results on deep respiratory samples. Patients with microbiologically confirmed HAP/VAP were compared to those without.
RESULTS: Among 190 patients, 69 (36%) had culture-confirmed HAP/VAP. Gram-negative bacilli (GNB) on Gram stain independently predicted true infection (OR = 3.08, 95% CI [1.47-6.45], P = 0.003). The false-negative rate for FA-PP-detectable bacteria was 12% (31/251), mainly Klebsiella pneumoniae and Pseudomonas aeruginosa. Nontargeted GNBs accounted for 27% (19/69) of confirmed cases. Recent broad-spectrum antibiotic exposure (≤3 months) reduced confirmed infection likelihood (OR = 0.28, 95% CI [0.13-0.6], P < 0.001). No inappropriate antibiotic de-escalation occurred, but 6% (7/121) of noninfected patients had antibiotics withdrawn based solely on FA-PP negativity.
CONCLUSIONS: Negative FA-PP results do not exclude HAP/VAP, especially with nontargeted GNBs or recent antibiotic exposure. Gram stain remains a valuable complementary tool. Integrated diagnostic approaches are essential for optimal antimicrobial stewardship in ICU settings.