The Clinical Significance of FilmArray Respiratory Panel in Diagnosing Community-Acquired Pneumonia

Chen, Huanzhu; Weng, Huilan; Lin, Meirui; He, Ping; Li, Yazhen; Xie, Qingdong; Ke, Changwen; Jiao, Xiaoyang

Nowadays, the golden standard for CAP diagnosis is still based on the chest radiography; however, a broad range of chest radiographic changes could be induced by various agents, a single and dual bacterium/virus, or mixed pathogens coinfections. These alterations of chest radiography are only helpful in specific cases to confirm a microbial cause of pneumonia [4] . Current diagnostic methods identify a pathogen in only 30%-40% of CAP patients [5, 6] , and the frequent lack of a microbiological diagnosis in CAP impairs pathogendirected antimicrobial therapy [7] . Polymerase chain reaction (PCR) technique has been shown to be reliable for diagnosing the pathogens, especially for those that are difficult to culture [4] . In addition, PCR method has high sensitivity and specificity in detecting multiple microorganisms and yields results faster than culture and serological methods [8] . Most importantly, the results of PCR are not affected by prior use of antibiotics. The findings indicate that the incidence of viral pneumonia in the past has been underestimated [4] . With multiple PCR assay, detection of multiple RNA or DNA targets in a single tube has the potential for rapid identification of complicated respiratory viral pathogens [9, 10] . The conventional techniques of microbial detection have high accuracy, but they are time-and labor-intensive, with limited range of detection and can be subjective, relying very much on technical expertise for the interpretation of cytopathic effect (CPE) in cell culture [11] . Direct fluorescent antibody assay (DFA) and immunochromatographic antigen testing, although rapid, have poor sensitivity for the detection of most viruses [12] . The serological methods also have low sensitivity. Therefore, an assay that is capable of rapid detection and accurate identification of multiple pathogens is desirable.