Microbial aetiology of community-acquired pneumonia in hospitalised adults: A prospective study utilising comprehensive molecular testing

• Published in: International journal of infectious diseases Vol. 143; p. 107019
• Main Authors: Markussen, Dagfinn Lunde, Kommedal, Øyvind, Knoop, Siri Tandberg, Ebbesen, Marit Helen, Bjørneklett, Rune Oskar, Ritz, Christian, Heggelund, Lars, Ulvestad, Elling, Serigstad, Sondre, Grewal, Harleen M.S.
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01.06.2024; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Community-Acquired Infections - diagnosis; Community-Acquired Infections - epidemiology; Community-Acquired Infections - microbiology; Community-acquired pneumonia; COVID-19 - diagnosis; Female; Haemophilus influenzae; Haemophilus influenzae - genetics; Haemophilus influenzae - isolation & purification; Hospitalization; Humans; Lower respiratory tract infections; Male; Microbial aetiology; Middle Aged; Molecular Diagnostic Techniques - methods; Molecular diagnostics; Norway - epidemiology; Pneumonia - diagnosis; Pneumonia - microbiology; Polymerase Chain Reaction - methods; Prospective Studies; SARS-CoV-2; SARS-CoV-2 - genetics; SARS-CoV-2 - isolation & purification; Streptococcus pneumonia; Streptococcus pneumoniae - genetics; Streptococcus pneumoniae - isolation & purification; Syndromic PCR panels; Norway; Lower respiratory tract infections; Molecular diagnostics; SARS-CoV-2; Syndromic PCR panels; Community-acquired pneumonia; Streptococcus pneumonia; Microbial aetiology; Haemophilus influenzae
• ISSN: 1201-9712; 1878-3511; 1878-3511
• DOI: 10.1016/j.ijid.2024.107019

•Prospective study on CAP microbial aetiology.•Hospitalised adults with CAP gave LRT samples in the ED.•A pathogen of clinical significance was identified in 81% of CAP patients.•Haemophilus influenzae and SARS-CoV-2 were the most prevalent pathogens.•The Filmarray pneumonia panel increased detection from 63% to 81%. This study aimed to describe the microbial aetiology of community-acquired pneumonia (CAP) in adults admitted to a tertiary care hospital and assess the impact of syndromic polymerase chain reaction (PCR) panels on pathogen detection. Conducted at Haukeland University Hospital, Norway, from September 2020 to April 2023, this prospective study enrolled adults with suspected CAP. We analysed lower respiratory tract samples using both standard-of-care tests and the BIOFIRE® FILMARRAY® Pneumonia Plus Panel (FAP plus). The added value of FAP Plus in enhancing the detection of clinically relevant pathogens, alongside standard-of-care diagnostics, was assessed. Of the 3238 patients screened, 640 met the inclusion criteria, with 384 confirmed to have CAP at discharge. In these patients, pathogens with proven or probable clinical significance were identified in 312 (81.3%) patients. Haemophilus influenzae was the most prevalent pathogen, found in 118 patients (30.7%), followed by SARS-CoV-2 in 74 (19.3%), and Streptococcus pneumoniae in 64 (16.7%). Respiratory viruses were detected in 186 (48.4%) patients. The use of FAP plus improved the pathogen detection rate from 62.8% with standard-of-care methods to 81.3%. Pathogens were identified in 81% of CAP patients, with Haemophilus influenzae and respiratory viruses being the most frequently detected pathogens. The addition of the FAP plus panel, markedly improved pathogen detection rates compared to standard-of-care diagnostics alone. [Display omitted]