Use of a molecular syndromic panel for the etiological diagnosis of ventilator-associated bacterial pneumonia: impact on clinical outcomes and antibiotic use from a multicenter, prospective study
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Ventilator-associated bacterial pneumonia (VABP) is a common infection in critically ill patients in intensive care units (ICU), with attributable mortality of up to 13%, and its etiological diagnosis remains challenging. MATERIALS AND METHODS: We conducted a multicenter, prospective, observational study within the MULTI-SITA platform to assess the impact on relevant clinical and antimicrobial stewardship outcomes of the use of a molecular syndromic panel (BIOFIRE® FILMARRAY® Pneumonia plus), in addition to a standard approach based on culture. The primary outcome measure was 30-day mortality from VABP onset. RESULTS: Overall, 237 patients with VABP were included in the study. In multivariable analysis, SOFA score (hazard ratio [HR] 1.13, 95% confidence interval [CI] 1.04–1.22, p = 0.003), previous isolation of carbapenem-resistant Pseudomonas aeruginosa (HR 3.02, 95% CI 1.25–7.32, p = 0.015), and solid neoplasm (HR 2.15, 95% CI 1.12–4.14, p = 0.022) were associated with increased mortality, while no association was registered for the molecular syndromic panel performed (HR 1.07, 95% CI 0.59–1.93, p = 0.825). In secondary analyses, use of the molecular syndromic panel resulted in more events of either de-escalation or initiation of appropriate antibiotic therapy at day 1 from VABP onset in comparison with a standard approach based on culture only (41.3% vs. 27.8%, p = 0.041). CONCLUSION: The use of a molecular syndromic panel in patients with VABP was able to impact antibiotic decisions, without an unfavorable effect on mortality. Further study is necessary to assess the long-term effects in terms of antimicrobial stewardship of molecular syndromic panels-based antibiotic treatment decisions.
Source: Critical Care
Authors: Daniele Roberto Giacobbe, Greta Cattardico, Claudia Bartalucci, Vincenzo Di Pilato, Marco Muccio, Alessandro Limongelli, Alessio Signori, Alessandra Bandera, Bruno Cacopardo, Edoardo Campanella, Alessandro Caroli, Annamaria Cattelan, Marta Colaneri, Andrea Cortegiani, Laura Curci, Gennaro De Pascale, Giuseppe Vittorio De Socio, Filippo Del Puente, Antonino Di Fede, Chiara Fanelli, Nicholas Geremia, Maddalena Giannella, Giacomo Grasselli, Chiara Maci, Ivana Maida, Davide Mangioni, Andrea Marino, Maria Mazzitelli, Maria Chiara Meloni, Marco Merli, Elena Momesso, Chiara Oltolini, Carlo Pallotto, Sandro Panese, Matteo Passerini, Emanuele Pontali, Daniele Riccucci, Matteo Rinaldi, Marco Ripa, Vincenzo Scaglione, Francesco Saverio Serino, Vincenzo Spagnuolo, Giulia Spurio, Stefania Tigano, Carlo Torti, Giovanna Travi, Laura Magnasco, Federica Portunato, Federica Briano, Malgorzata Mikulska, Lorenzo Ball, Chiara Robba, Nicolò Patroniti, Denise Battaglini, Mauro Giacomini, Gian Maria Rossolini, Maurizio Sanguinetti, Paola Morici, Anna Marchese, Antonio Vena, Matteo Bassetti, RAPID-SITA PHENOTYPES investigators, Ylenia Murgia, Gabriele Di Meco, Alice Cappello, Sabrina Guastavino, Cristina Campi, Michele Piana, Sara Mora, Nicola Rosso, Antonio Di Biagio, Giulia Viglietti, Annaflavia Lamarina, Luca De Paola, Stefano Antola, Selene Gallone, Federica Cosentino, Chiara Gullotta, Marco Piscaglia, Federico D’Amico, Serena Sassi, Elena Simoncini, Giacomo Gonnelli, Anna Gidari, Lisa Malincarne, Nicoletta Bobbio, Andrea Parisini, Annalisa Garlaschelli, Sara Grignolo, Fabiola Cammarota, Paola Del Giacomo, Brunella Posteraro, Andrea Lombardi, Antonio Muscatello, Carlo Peri, Mara Tomasello, Nicoletta Boffa, Elena Potenza, Antonella Castagna, Roberta Monardo, Giulia Catalisano, Michela Di Maio, Antonino Giarratano, Mariachiara Ippolito, Pierluigi Viale
Institutions: Ospedale Policlinico San Martino, University of Genoa, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Catania, Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, University of Padua, Azienda Ospedale - Università Padova, Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone" di Palermo, University of Palermo, University of Perugia, Ente Ospedaliero Ospedali Galliera, University of Sassari, Ospedale dell' Angelo, University of Bologna, Vita-Salute San Raffaele University, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Ospedale di San Donà di Piave, Luigi Sacco Hospital, IRCCS Ospedale San Raffaele, Azienda Ospedaliero-Universitaria Careggi, University of Florence
Language: English
Topic: Nosocomial Infections in ICU
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,190
Funder: bioMérieux
Award: G3261989428
OpenAlex ID: W4414511361