BioFire® FilmArray®檢測平臺於嚴重特殊傳染性肺炎大流行期間的臨床應用

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Title:	BioFire® FilmArray®檢測平臺於嚴重特殊傳染性肺炎大流行期間的臨床應用
Other Titles:	The Clinical Application of BioFire� FilmArray� Platform During the COVID-19 Pandemic
Authors:	陳瑩儒 CHEN, YING-JU
Contributors:	余志強 ER, TZE-KIONG 醫學檢驗暨生物技術學系
Keywords:	肺炎病原體多標的聚合酶連鎖反應;呼吸道病原體多標的聚合酶連鎖反應;微晶;新型冠狀病毒;可霸斯萊特 pneumonia panel;respiratory panel;Filmarray;SARS-CoV-2;cobas Liat
Date:	2023
Issue Date:	2023-11-22
Abstract:	本研究主要利用BioFire® FilmArray®平臺分析在嚴重特殊傳染性肺炎大流行期間，急診患者的呼吸道病毒之病原體分布，以及加護病房患者下呼吸道檢體之病毒或細菌病原體分布情形。在2020年5月至2022年9月至急診室求診患者，年齡分布介於0.1至98歲，以鼻咽拭子檢體利用BioFire® FilmArray® Respiratory Panel （RP）進行檢測，期間測試804位患者，共有225 （27.9%）件陽性結果，其中鼻病毒/腸病毒為最常被測得的病原體，共170 （61.8%）件，接續為腺病毒38 （13.8%）件，SARS-CoV-2 16 （5.8%）件；當SARS-CoV-2 為陽性結果時則利用cobas® Liat® 系統重複測試以確認檢驗結果，從結果可得知以cobas® Liat® SARS-CoV-2 和 influenza A/B核酸檢測以及BioFire® FilmArray® RP結果完全一致，由此可見BioFire® FilmArray® RP可用於偵測SARS-CoV-2。另外，在2022年4月至12月期間，於加護病房患者年齡分布介於37到85歲，採集其下呼吸道檢體以BioFire® FilmArray® pneumonia panel （PP）檢測並分析其病原體分佈的分佈情形，測試件數為54件，共25（46.3%）件陽性結果，克雷伯氏肺炎菌群、綠膿桿菌及金黃色葡萄球菌為測試期間最常見的病原體，分別共有8 （16.3%）件，接續為大腸桿菌共5（10.2 %）件。總體而言，BioFire® FilmArray® RP and PP 可以提升呼吸道多重感染的偵測能力，不論感染病症由病毒或非典型之細菌所引起。在嚴重特殊傳染性肺炎大流行期間，這兩項檢測對於急診和加護病房患者提供了病原體的快速檢測，同時亦可以加強臨床治療決策，以提供患者最適切的照護。 This study was conducted to evaluate the distribution of respiratory viral pathogens in the emergency department and the distribution of viral and bacterial pathogens in lower respiratory tract specimens in ICU during the coronavirus disease 2019 (COVID-19) pandemic. Between May 2020 and September 2022, patients aged between 0.1 and 98 years arrived at the emergency department of Asia University Hospital, and samples from nasopharyngeal swabs were tested by the BioFire� FilmArray� Respiratory Panel (RP). There were 804 patients for whom the BioFire� FilmArray� RP was tested, and 225 (27.9%) of them had positive results for respiratory viruses. Rhinovirus/enterovirus was the most commonly detected pathogen, with 170 (61.8%) cases, followed by adenovirus with 38 (13.8%), SARS-CoV-2 with 16 (5.8%) cases. SARS-CoV-2 positivity was subsequently retested by the cobas� Liat� system. Our results showed that there was prefect agreement between the detection of SARS-CoV-2 conducted with the cobas� Liat� SARS-CoV-2 and influenza A/B nucleic acid test and the BioFire� FilmArray� RP. Therefore, the BioFire� FilmArray� RP assay is a reliable and feasible method for the detection of SARS-CoV-2. Between April 2022 and December 2022, patients aged between 37 and 85 years in an intensive care unit (ICU) of Asia University Hospital, and specimens from lower respiratory tract were analyzed by the BioFire� FilmArray� pneumonia panel (PP) assay. There were 54 patients for whom the BioFire� FilmArray� PP assay was tested, and 25 (46.3%) of them had positive results for viral and/or bacterial pathogens in lower respiratory tract specimens. Klebsiella pneumoniae group, Pseudomonas aeruginosa, and Staphylococcus aureus were the most commonly detected pathogen, with 8 (16.3%) cases, respectively, followed by Escherichia coli with 5 (10.2 %) cases. In summary, BioFire� FilmArray� RP and PP assay significantly broaden our capability to detect multiple respiratory infections due to viruses and atypical bacteria. It provides a prompt evaluation of pathogens to enhance patient care and clinical selection strategies in emergency departments and ICU during the COVID-19 pandemic.
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