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

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.

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).

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.

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