Epidemiology and prediction of non-targeted bacteria by the filmarray pneumonia plus panel in culture-positive ventilator-associated pneumonia: a retrospective multicentre analysis
Authors' conclusion
A significant rate of culture-positive VAP cases with non-targeted bacteria was observed in this study, raising concerns about the interpretation of FAPPP results.
Study context
- Population
- Culture-positive Ventilator-associated Pneumonia (VAP) episodes in 12 Intensive Care Units (ICUs) in France, January 2016 to March 2021
- Participants
- 332 participants · 385 VAP episodes
- Outcome
- Prevalence of non-targeted bacteria (species isolated during VAP, not included in the BioFire FilmArray Pneumonia Panel, but considered in final antibiotic therapy)
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
VAP episodes with non-targeted pathogens (87/385)
23%
Non-targeted bacteria among isolated bacteria (110/534)
21%
VAP with non-targeted bacterium after excluding low-pathogenicity bacteria
21%
Most common non-targeted bacterium: Stenotrophomonas maltophilia
22%
Observational data: associations, not effects.
Further findings
Gram stain concordance with definitive cultures
- Concordance
- 42%
Non-targeted bacteria by ICU
- Range between ICUs
- 12 to 37%
- p = 0.013
Non-targeted bacteria, polymicrobial vs other VAP
- Polymicrobial vs other
- 47% vs. 25%
- p < 0.001
Non-targeted bacteria, in-ICU antibiotic exposure (multivariate)
- Exposed vs not exposed
- 25.3% vs. 12.9%
- p = 0.042
Non-targeted bacteria, age over 70 years (multivariate)
- Threefold increased risk
- p = 0.027
Ineffective empiric treatment (48 VAP cases)
- Involved targeted bacteria
- 67%
- Of these, could have received effective empirical therapy with panel results
- 59%
Original publication
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