Evaluation PCR panel of the FilmArray® pneumonia plus for pathogen detection of ventilator-associated pneumonia in children and its impact on therapeutic management

Fayrouz Debbagh; Toufik Ben Houmich; Morad Guennouni; Houssameddine Sahraoui; Asma Lamrani Hanchi; Youssef Mouaffak; Said Younous; Nabila Soraa

doi:10.18502/ijm.v15i1.11914

Evaluation PCR panel of the FilmArray® pneumonia plus for pathogen detection of ventilator-associated pneumonia in children and its impact on therapeutic management

Iran J Microbiol. 2023 Feb;15(1):19-26. doi: 10.18502/ijm.v15i1.11914.

Authors

Fayrouz Debbagh¹, Toufik Ben Houmich¹, Morad Guennouni², Houssameddine Sahraoui³, Asma Lamrani Hanchi¹, Youssef Mouaffak³, Said Younous³, Nabila Soraa¹

Affiliations

¹ Laboratory of Microbiology, Faculty of Medicine and Pharmacy, Mohamed VI University Hospital Center, Cadi Ayyad University, Marrakesh, Morocco.
² Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences of Settat, Hassan First University of Settat, Settat, Morocco.
³ Department of Pediatric Intensive Care, Faculty of Medicine and Pharmacy, Mohamed VI University Hospital Center, Cadi Ayyad University, Marrakesh, Morocco.

Abstract

Background and objectives: Ventilator-associated pneumonia (VAP) is the second most common nosocomial infection in pediatric intensive care units. The aim of this study was to evaluate the contribution of multiplex PCR in the diagnosis of VAP and its impact on the clinical and prognostic outcome of children in the ICU.

Materials and methods: This is a prospective observational study from March to November 2021, including bronchial samples collected from 38 intubated children hospitalized in ICU. The detection of respiratory pathogens was performed by the FilmArray® Pneumonia Panel plus (FAPP).

Results: Multiplex PCR (mPCR) detected exclusively 46 potentially pathogenic bacteria, giving a sensitivity of 93%, specificity of 90%, negative predictive value of 100%, and positive predictive value of 23%. Overall, the sensitivity of mPCR was higher for Gram-negative bacteria (100%) than Gram-positive (92%). Bacterial etiology was the most frequent (69.3%), represented mainly by Moraxella catarrhalis (11.4%), followed by viral etiology (30.7%), with Rhinovirus/Enterovirus as the most prevalent virus. FAPP enabled a change in antibiotic therapy in 39.5% of the patients, with a 73.3% survival rate.

Conclusion: This study highlights the importance of mPCR in diagnosing VAP and improving antimicrobial therapy.

Keywords: Antimicrobial stewardship; Children; Intensive care units; Multiplex polymerase chain reaction; Ventilator-associated pneumonia.