Respiratory viruses cause significant morbidity and mortality, particularly among the elderly, children, and immunocompromised individuals. There are an estimated 200,000 hospitalizations due to influenza and 125,000 RSV-related hospitalizations in the U.S. annually. Parainfluenzas, human metapneumovirus and adenoviruses can cause respiratory disease that is clinically indistinguishable from illness caused by influenza and RSV. Bacterial atypical pneumonia pathogens include Mycoplasma pneumoniae and Chlamydophila pneumoniae. M. pneumoniae typically infects younger age groups, while C. pneumoniae has a higher incidence in the elderly. Long-lasting immunity does not occur following infection with either organism.
Traditional methods for detection of respiratory pathogens include rapid antigen detection tests, direct fluorescent antibody (DFA) staining, culture, and serology. None of these methods is ideal for diagnostic purposes. Respiratory pathogen panels based on PCR became available in 2013.
Biofire’s Filmarray Respiratory Panel combines PCR and gene array technology to detect 17 viral and 3 bacterial pathogens, including respiratory syncytial virus, influenza A and B, parainfluenza 1 through 4, human metapneumovirus, adenovirus, rhinovirus/enterovirus, coronavirus NL62. Mycoplasma pneumoniae, Chlamydia pneumoniae, and Bordetella pertussis. Testing can be performed on nasopharyngeal swabs, nasal washes and bronchoscopy specimens.
Recently, Rogers, etal published an important article that compared the outcomes of children three months or older who were admitted to the hospital with an acute respiratory infection before and after implementing FilmArray Respiratory Panel. The results showed that implementing the rapid respiratory panel reduced the mean time to test result and increased the percentage of patients who received a result while in the emergency room. Duration of antibiotic use was shorter if results were reported within four hours after ordering. Length of stay and time in isolation were both reduced. Introduction of FilmArray Respiratory Panel significantly improved patient outcomes.
Rogers BB, Shankar P, Jerris RC, et al. Impact of a rapid respiratory panel test on patient outcomes. Arch Pathol Lab Med. 2015;139:636–641.