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Pneumonia panel by FilmArray (Biofire) - Lower Respiratory Tract
Bacterial/ Viral
Report in 48Hrs
At Home
No Fasting Required
Details
Multiplex PCR for pathogens.
₹39,442₹56,346
30% OFF
Pneumonia Panel by FilmArray (Biofire) - Lower Respiratory Tract
- Why is it done?
- Rapid identification of bacterial, viral, and fungal pathogens causing community-acquired pneumonia and healthcare-associated pneumonia using multiplex polymerase chain reaction (PCR) technology
- Evaluation of patients presenting with signs and symptoms of lower respiratory tract infection including fever, productive cough, dyspnea, and chest discomfort
- Guidance for appropriate empiric antimicrobial therapy selection and de-escalation strategies to optimize clinical outcomes and reduce antibiotic resistance
- Differentiation between bacterial, viral, and atypical pathogens to guide targeted treatment decisions
- Assessment of hospitalized patients with pneumonia, immunocompromised patients, or those with severe respiratory illness
- Epidemiologic surveillance and detection of emerging respiratory pathogens during seasonal outbreaks or pandemics
- Normal Range
- Normal Result: NEGATIVE or NOT DETECTED for all targeted respiratory pathogens. This indicates no evidence of lower respiratory tract infection from bacteria, viruses, or fungi included in the panel.
- Units of Measurement: Qualitative result (Detected/Not Detected) for each organism; results are reported individually for each pathogen in the panel.
- Result Interpretation: Results are dichotomous (positive or negative) for each organism. A negative result indicates the specific organism was not detected in the lower respiratory specimen. Multiple positive results may occur indicating polymicrobial infection.
- Clinical Significance: Negative results suggest absence of bacterial, viral, or fungal pneumonia; however, clinical correlation is essential as negative results do not exclude atypical pathogens or other causes of respiratory disease.
- Interpretation
- Positive Results: Detection of one or more organisms indicates likely infection. Bacterial pathogens detected may include Streptococcus pneumoniae, Haemophilus influenzae, Legionella species, Mycoplasma pneumoniae, and Chlamydophila pneumoniae. Viral pathogens may include influenza A/B, respiratory syncytial virus (RSV), parainfluenza, rhinovirus, enterovirus, coronavirus, adenovirus, and metapneumovirus. Fungal organisms may include Pneumocystis jirovecii.
- Negative Results: No detection of targeted organisms. Clinical correlation is crucial as some respiratory pathogens are not included in the panel (e.g., some atypical organisms, certain environmental fungi, or less common bacterial species).
- Polymicrobial Infections: Multiple organisms detected simultaneously may indicate co-infection or superinfection. This is particularly common in hospitalized patients, immunocompromised individuals, or those with prolonged respiratory illness.
- Factors Affecting Results: Quality and timing of specimen collection, appropriate specimen type (bronchoalveolar lavage, endotracheal aspirate, sputum), contamination with upper airway flora, prior antimicrobial therapy, immunosuppression status, and underlying comorbidities may all influence result interpretation.
- Clinical Significance of Specific Pathogens: Detection of certain organisms carries specific treatment implications. For example, Legionella detection necessitates fluoroquinolone or macrolide therapy; Mycoplasma detection suggests macrolide or fluoroquinolone coverage; influenza detection may warrant neuraminidase inhibitor therapy; RSV detection in vulnerable populations may guide supportive care intensity.
- Specimen Quality: Lower respiratory specimens (bronchoalveolar lavage, endotracheal aspirate) provide superior diagnostic accuracy compared to sputum, particularly in intubated patients or those unable to produce adequate specimens.
- Associated Organs
- Primary Organ Systems: Lungs and lower respiratory tract (including bronchi, bronchioles, and alveoli); the test specifically targets lower respiratory infections and does not detect upper airway pathogens.
- Associated Diseases and Conditions: Community-acquired pneumonia (CAP), healthcare-associated pneumonia (HCAP), hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), atypical pneumonia, viral pneumonia, opportunistic infections in immunocompromised patients, and respiratory tract co-infections.
- Conditions Commonly Associated with Abnormal Results: Fever, cough, dyspnea, hypoxemia, abnormal lung imaging findings, patients on mechanical ventilation, immunosuppression (HIV/AIDS, chemotherapy, organ transplantation), advanced age, chronic lung disease (COPD, asthma), cardiovascular disease, diabetes mellitus, and smoking history.
- Potential Complications: Sepsis, acute respiratory distress syndrome (ARDS), respiratory failure requiring mechanical ventilation, bacteremia/fungemia with systemic dissemination, pleural effusion or empyema, necrotizing pneumonia, lung abscess, and multiple organ dysfunction.
- Secondary Organ Involvement: Untreated or severe pneumonia may result in secondary involvement of the cardiovascular system (septic shock, myocardial infarction), central nervous system (meningitis), hepatic system, and kidneys (acute kidney injury), particularly with Legionella and Pneumocystis infections.
- Follow-up Tests
- Microbiology Cultures: Bacterial and fungal cultures from the same specimen to obtain isolate for susceptibility testing and antimicrobial resistance determination; recommended for all hospitalized patients.
- Blood Cultures: Recommended in hospitalized patients with pneumonia to detect bacteremia/fungemia, guide antimicrobial therapy, and establish diagnosis of invasive infection.
- Complete Blood Count (CBC): Assess for leukocytosis, leukopenia, or lymphopenia; particularly useful in differentiating viral from bacterial infections and assessing immune function.
- Comprehensive Metabolic Panel (CMP): Evaluate renal function, electrolytes, and liver function; assess for complications and severity of infection.
- Inflammatory Markers: C-reactive protein (CRP) and procalcitonin useful for assessing inflammatory response, predicting bacterial infection, and monitoring therapeutic response.
- Imaging Studies: Chest X-ray, high-resolution CT chest for diagnosis confirmation, assessment of pneumonia extent, detection of complications (pleural effusion, empyema, abscess), and evaluation of suspected atypical presentations.
- Antigen Testing: Legionella and pneumococcal antigen detection in urine; rapid point-of-care testing for influenza and RSV for specific antiviral guidance.
- Immunological Testing: HIV testing in patients with Pneumocystis jirovecii detection; CD4 count assessment for immunocompromised patients to guide opportunistic infection prophylaxis.
- Monitoring Frequency: Repeat FilmArray testing not routinely recommended unless clinical deterioration occurs or response to therapy is inadequate; clinical reassessment and imaging at 48-72 hours or per clinical judgment.
- Treatment Response Monitoring: Clinical assessment, vital signs monitoring, oxygen requirements, inflammatory markers, and imaging follow-up to assess response to targeted antimicrobial therapy.
- Fasting Required?
- Fasting Required: NO. This is a respiratory specimen test that does not require fasting or special nutritional preparation.
- Specimen Collection Requirements: Lower respiratory specimens required: bronchoalveolar lavage (BAL) fluid, endotracheal aspirate (ETA), sputum, or lower respiratory tract secretions. Proper specimen collection technique is critical for diagnostic accuracy.
- Pre-test Patient Preparation: No special preparation necessary. Patient should avoid using throat lozenges, mouthwash, or oral antiseptics immediately before specimen collection; maintain normal oral hygiene.
- Medications: No medications need to be withheld for specimen collection. However, recent antibiotic use may reduce diagnostic yield; specimen should ideally be obtained prior to antimicrobial therapy initiation when possible, though this is not always feasible in acute care settings.
- Specimen Handling and Transport: Use sterile, sealed containers; maintain specimens at room temperature (do NOT refrigerate); transport to laboratory promptly (ideally within 1-2 hours); document specimen type and collection method clearly on specimen label.
- Specimen Adequacy: BAL and ETA specimens are preferred for accuracy and minimized upper airway contamination. Sputum must be deep, expectorated lower respiratory secretions (not saliva). Insufficient or inadequate specimens may result in non-reportable results.
- Timing Considerations: Test can be performed at any time; no circadian variation or timing restrictions. Results typically available within 1-2 hours, making this an ideal rapid diagnostic tool for acute clinical decision-making.
How our test process works!
