Implementation of the filmarray pneumonia panel in patients with nosocomial pneumonia. a quasi-experimental study

Abstract

BACKGROUND: Hospital-acquired pneumonia is a frequent nosocomial infection in patients admitted to internal medicine wards and a major cause of antibiotic overuse. Standard culture methods currently take at least five days to identify pathogens and their antibiotic susceptibility, leading to broad-spectrum empirical treatment. This widespread practice increases the risk of acquiring multi-drug resistant organisms, thereby exacerbating antibiotic resistance. New molecular diagnostic methods, such as FilmArray rapid multiplex PCR, offer an alternative to reduce pathogen identification time to less than one hour, as well as associated multiresistance, potentially improving patient outcomes and reducing the development of multidrug-resistant organisms, thus addressing the global challenge of antibiotic resistance. OBJECTIVES: To assess whether the implementation of molecular testing using FilmArray and subsequent targeted treatment of nosocomial pneumonias, as opposed to conventional culture and empirical treatment, will improve long-term hospital antimicrobial resistance and clinical patient outcomes, reducing associated complications, hospital stays, readmissions and mortality rates. STUDY PARTICIPANTS: This study includes adult patients (≥18 years) admitted to Santa Caterina Hospital, diagnosed with hospital-acquired pneumonia, and able to provide a sufficient volume of sputum sample obtained to perform FilmArray. DESIGN AND METHODS: This is a prospective, single-centre, quasi-experimental study. The study will consist of a before and after evaluation, where in the first phase (pre-intervention) 37 participants will be enrolled, diagnosed using conventional culture and empirically treated. In the second phase of the study (post-intervention), 111 patients will be recruited and the FilmArray Pneumonia Panel will be implemented. These patients will receive treatment based on the results obtained from the technique. The aim is to determine if this intervention can reduce antibiotic resistance at Santa Caterina Hospital. The study will last for a total of 5 years