기관지 폐포세척액에서 세균성 폐렴원인균과 항균제내성 유전자 검출을 위한 BioFire FilmArray pneumonia panel의 성능 평가
Evaluation of the BioFire FilmArray Pneumonia Panel for the Detection of Bacterial Respiratory Pathogens and Antimicrobial Resistance Genes in Endotracheal Aspirate Specimens
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배경: 하기도 감염에서 병원균에 대한 신속한 진단은 환자의 치료에 필수적이다. 저자들은 기관지 폐포세척액에서 병원성 세균과 항균제내성 유전자 검출에 대한 Biofire FilmArray pneumoniapanel (FA-PE; BioFire Diagnostics, USA)의 수행능을 평가하고자 하였다. 방법: 총 43개의 기관지 폐포세척액을 대상으로 하였다. FA-PE의 수행능은 기존 배양법을 기준으로 평가하였다. 결과: FA-PE는 15개의 호흡기 병원균 동정에 있어서 기존 배양법과 비교하여 92.9%의 민감도와79.3%의 특이도를 보였다. 항균제 내성 유전자는 43개 검체 중 4개를 검출하였으며 가장 흔한 유전자는 mecA/C로 3개였고 CTX-M 유전자가 1개 검출되었다. 결론: FA-PE 검사는 하기도 감염을 위한 신속한 진단법으로 향후 폐렴 환자를 조기 치료하는데 유용할 것으로 사료된다.
Abstract
Background: Rapid detection of the causative agents is essential for determining theappropriate treatment for patients with lower respiratory tract infections. We evaluated theperformance of the Biofire FilmArray pneumonia panel (FA-PE; BioFire Diagnostics, USA)in the identification of bacterial pathogens and antibiotic resistance genes in endotrachealaspirate specimens. Methods: A total of 43 non-duplicated endotracheal aspirates were included in this study. Theperformance of the FA-PE was assessed using the routine culture method as the referencestandard. Results: The FA-PE demonstrated 92.9% sensitivity and 79.3% specificity for the identificationof 15 bacterial targets compared to routine bacterial culture. Four antimicrobial resistancegenes in 43 specimens were detected by the FA-PE. The most frequently detected resistancegenes were mecA/C and SCCmec in three specimens, followed by CTX-M in one specimen. Conclusion: The FA-PE offers a rapid diagnostic method for lower respiratory tract infections. It may be useful at the early stage of pneumonia, before routine culture and antimicrobialsusceptibility results are available.
참고문헌 (12)
- "GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systemic analysis for the Global Burden of Disease Study 2017", Lancet, 392, pp.1736~1788 (2018)
- Iregui M, "Clinical importance of delays in the initiation of appropriate antibiotic treatment for ventilator-associated pneumonia", Chest, 122, pp.262~268 (2002)
- Prats E, "Effects of antibiotics on protected specimen brush sampling in ventilator-associated pneumonia", Eur Respir J, 19, pp.944~951 (2002)
- Gadsby NJ, "Development of two real-time multiplex PCR assays for the detection and quantification of eight key bacterial pathogens in lower respiratory tract infections", Clin Microbiol Infect, 21, pp.788.e1~13 (2015)
- Papan C, "Assessment of the multiplex PCR-based assay Unyvero pneumonia application for detection of bacterial pathogens and antibiotic resistance genes in children and neonates", Infection, 46, pp.189~196 (2018)
- Leber AL, "Clinical microbiology procedures handbook" (2016), ASM Press
- Murphy CN, "Multicenter evaluation of the Biofire FilmArray pneumonia", pneumonia plus panel for detection and quantification of agents of lower respiratory tract infection, 2020, pp.58, e00128~00120
- Rocchetti TT, "Detection of the mecA gene and identification of Staphylococcus directly from blood culture bottles by multiplex polymerase chain reaction", Braz J Infect Dis, 22, pp.99~105 (2018)
- Uzoamaka M, "Bacterial etiology of lower respiratory tract infections and their antimicrobial susceptibility", Am J Med Sci, 354, pp.471~475 (2017)
- Ramanan P, "Syndromic panel-based testing in clinical microbiology", Clin Microbiol Rev, 31, pp.e00024~17 (2018)
- Lee SH, "Performance of a multiplex PCR pneumonia panel for the identification of respiratory pathogens and the main determinants of resistance from the lower respiratory tract specimens of adult patients in intensive care units", J Microbiol Immunol Infect, 52, pp.920~928 (2019)
- Yoo IY, "Evaluation of the BioFire FilmArray pneumonia panel for rapid detection of respiratory bacterial pathogens and antibiotic resistance genes in sputum and endotracheal aspirate specimens", Int J Infect Dis, 95, pp.326~331 (2020)