Multiplex pneumonia panel for diagnosis of critically ill pneumonia patients in a tertiary care setting: A retrospective study

PURPOSE: Acute respiratory infections (ARIs) are a major global health concern, causing over 4 million deaths annually, particularly in developing countries. Traditional diagnostic methods, such as microbial culture, are slow, leading to delayed treatment and increased antimicrobial resistance (AMR). This study evaluates the BIOFIRE Pneumonia Plus panel, a multiplex PCR-based assay, for detecting bacterial and viral pathogens and AMR genes in bronchoalveolar lavage (BAL) specimens. METHODS: A method-comparison study was conducted in a tertiary care setting using identified clinical data over one year. BAL specimens were analyzed using the BIOFIRE Pneumonia Plus panel and standard culture, and their results and turnaround times were compared. RESULTS: Among 303 specimens, the BIOFIRE Pneumonia Plus panel detected pathogens in 70.3 % of cases, significantly outperforming standard culture (14.85 %). The most frequently identified bacteria were Pseudomonas aeruginosa (20.08 %), Klebsiella pneumoniae (17.15 %), and Haemophilus influenzae (16.31 %). The most common viruses detected were human rhinovirus/enterovirus (18.81 %) and influenza A (9.24 %). AMR genes were found in 24.09 % of cases, with CTX-M and NDM being the most prevalent. The BIOFIRE panel provided results in 2 h 35 min, compared to 56 h 46 min for standard culture. CONCLUSION: The BIOFIRE Pneumonia Plus panel enables rapid and accurate pathogen detection, improving clinical decision-making and supporting antimicrobial stewardship. Despite limitations such as the detection of colonizers or non-viable microorganisms, it is a valuable tool for enhancing ARI diagnostics and guiding targeted therapy.