Pathogen detection by multiplex PCR: A comparative study of pneumonia panel, bacterial culture, and respiratory panel in Japanese patients.

BACKGROUND

Recently developed molecular diagnostic tools facilitate rapid pathogen detection; however, their clinical application in Japan remains limited due to insufficient comparative data. This study aimed to evaluate the pathogen detection rates of the pneumonia panel relative to bacterial culture and compare viral detection rates between pneumonia and respiratory panels in Japanese patients.

METHODS

This retrospective study included 354 Japanese patients with suspected respiratory infections. Pathogen detection was performed using the BioFire® FilmArray® Pneumonia and Respiratory 2.1 panels. A total of 403 specimens were analyzed with the pneumonia panel, 223 of which were also tested using the respiratory panel, and 373 underwent simultaneous bacterial culture.

RESULTS

The pneumonia panel demonstrated a significantly higher positivity rate (60.3 %) than bacterial culture (52.8 %), exhibited substantial concordance (77.2 %) with bacterial culture results, and identified viral co-infections. Among the specimens, sputum exhibited a markedly higher positivity rate (64 %) within the pneumonia panel. Staphylococcus aureus isolates harboring resistance genes exhibited significantly higher culture positivity rates, whereas Enterobacter cloacae complex isolates lacking resistance genes were more frequently recovered in culture. The detection rates of Rhinovirus/Enterovirus and Respiratory syncytial virus were comparable between the pneumonia and respiratory panels, despite using different specimen types.

CONCLUSION

The pneumonia panel showed superior pathogen detection compared to bacterial culture, reinforcing its clinical value in pneumonia management. Comparable viral detection between pneumonia and respiratory panels suggests diagnostic interchangeability. These findings provide Japan-specific evidence, where insurance coverage remains limited, supporting molecular diagnostics to improve respiratory infection management and guide future healthcare policy decisions.