Multiplex tests for respiratory tract infections, direct utility of FilmArray respiratory panel in the emergency department

Abstract BackgroundThe FilmArray respiratory panel with 20 targets for viral and atypical pathogens aimed at point of care tests, as multiplex tests for respiratory tract infections it has been widely used and verified in various clinical trials. The FilmArray respiratory panel (FilmArray RP) seems to be a reliable and rapid tool in special tests settings such as clinical laboratory, and it’s necessary to evaluate the panel’s performance in point of care directly with non-specific tests settings. MethodsIn this single-centre, open, observational study, we enrolled outpatients with respiratory tract infection from emergency department during 2016-2017 winter season, specimens from participants were detected using FilmArray RP. All steps including recruitment, collection of specimens and testing were performed by our clinical staff. The results of pathogens detected, clinical and demographic data were collected and analyzed. ResultsBetween October 2016 and May 2017, we enrolled 271 eligible patients, FilmArray RP was successful used in 270 patients: 196 (72.6 %) patients had been detected with one or more pathogens, 74 (27.4) patients got negative results; in the analysis of signal pathogen detected, influenza A virus had the highest rate of detection, and the rate in group ≤ 16 years, 16-49 years and ≥ 50 years was 22.8 %, 32.4 %, 31.1 % respectively; 45 (16.7 %) patients were co-detected with two or more respiratory pathogens, most multiplex pathogens were rhinovirus/enterovirus co-detected with Bordetella. pertussis (17.8 %). The outcomes provided by FilmArray RP had impact on the prescriptions of antimicrobials, there were difference in the rates of antibiotic prescriptions and anti-influenza prescriptions among patients with Flu A/B virus detected, non-Flu A/B virus pathogen detected and non-pathogen.ConclusionsThe performance of FilmArray RP using by clinical staffs was successfully implemented in emergency department for which is the first time in China. The multiplex diagnostic system significantly increased the rate of respiratory pathogens detected in diagnostic methods limited hospital. Despite this, FilmArray RP has a potential use as a tool for point of care testing in non-specific setting and operated by clinical staffs not in a laboratory.