Test Code LAB10012 Pneumonia PCR with aerobic culture and Gram stain
Performing Laboratory
Barnes-Jewish Hospital Molecular Infectious Disease (PCR) and Microbiology (aerobic culture and Gram stain) Laboratories
Methodology
Multiplex Polymerase chain reaction (PCR) with corresponding aerobic culture and Gram stain.
The Pneumonia Panel PCR detects viral and bacterial causes of pneumonia (Table 1). Viral pathogens will be reported qualitatively (i.e. “detected” or “not detected”). The bacterial targets will be reported in semi-quantitative bins (i.e. 10^4, 10^5, 10^6 and ≥10^7 copies/mL). Some molecular markers of antimicrobial resistance will also be available for the bacterial targets. When compared to culture, the pneumonia panel has shown high sensitivity for bacterial targets, with an excellent negative predictive value for on-panel targets.
Table 1. BioFire Pneumonia Panel Targets |
|
Viruses |
Adenovirus |
Coronavirus (not SARS-CoV-2) |
|
Human metapneumovirus |
|
Human rhinovirus/enterovirus |
|
Influenza A |
|
Influenza B |
|
Parainfluenza virus |
|
Respiratory syncytial virus |
|
Bacteria (reported with semi-quantification) |
Acinetobacter calcoaceticus-baumannii complex |
Enterobacter cloacae complex |
|
Escherichia coli |
|
Haemophilus influenzae |
|
Enterobacter aerogenes |
|
Klebsiella oxytoca |
|
Klebsiella pneumoniae group |
|
Moraxella catarrhalis |
|
Proteus spp. |
|
Pseudomonas aeruginosa |
|
Serratia marscens |
|
Staphylococcus aureus |
|
Streptococcus agalactiae |
|
Streptococcus pneumoniae |
|
Streptococcus pyogenes |
|
Atypical Bacteria (not quantified) |
Chlamydia pneumoniae |
Mycoplasma pneumoniae |
|
Legionella pneumophila |
|
Antimicrobial Resistance Genes |
mecA/C and MREJ (S. aureus) |
blaoxa-48 (Enterobacterales) |
|
blavim (Enterobacterales) |
|
blaimp (Enterobacterales) |
|
blakpc (Enterobacterales) |
|
blaNDM-1 (Enterobacterales) |
|
blaCTX-M (Enterobacterales) |
NOTE: While the Pneumonia panel PCR detects seasonal coronaviruses, it does not detect SARS-CoV-2 (COVID-19).
Literature References:
Webber DM, Wallace MA, Burnham CA, Anderson NW. Evaluation of the BioFire FilmArray Pneumonia Panel for Detection of Viral and Bacterial Pathogens in Lower Respiratory Tract Specimens in the Setting of a Tertiary Care Academic Medical Center. JCM 2020 Jun 24;58(7):e00343-20
Hughes AEO, Webber DM, Wallace MA, Johnson C, Burnham CA, Anderson NW. Comparable Detections of Viral Pathogens in Lower Respiratory Tract Specimens with the BioFire Respiratory Panel 2 and the BioFire Pneumonia Panel
Specimen Requirements
Acceptable Specimens:
Sputum, tracheal aspirates, bronchial washing, bronchial alveolar lavage
Collection Procedure:
- Aseptically collect > 1 mL of specimen.
- Place in a leakproof screw-capped, sterile container.
- Maintain sterility and forward to laboratory promptly
Unacceptable specimens:
Nasopharyngeal swab, nasal swab, saliva
Day(s) Test Set Up
Monday – Sunday, 24 hours
Turnaround Time: 8 hours
Test Classification and CPT Coding
87633 – Respiratory virus multiplex, 12-25 targets
87070 – Culture, aerobic (not stool, rectal swab, or urine)
87205 – Gram stain
87181 – Susceptibility, agar diffusion (if appropriate)
87184 – Susceptibility, disk diffusion (if appropriate)
84185 – Susceptibility, enzyme detection (if appropriate)
87186 – Susceptibility, microdilution (if appropriate)
Reference Values
Not Detected
Test Limitations
Qualitative and quantitative results may differ from those obtained by culture. Final interpretation of Pneumonia Panel results should be in context with results obtained from culture.
While the Pneumonia panel PCR detects seasonal coronaviruses, it does not detect SARS-CoV-2 (COVID-19).
Specimen Transport Temperature
Specimens should be forwarded to the laboratory immediately for testing.
If immediate forwarding is not possible, specimens should be refrigerated at 2-8˚C.
Refrigerated specimens must be tested within 24 hours.
Requests to add on Pneumonia PCR to existing respiratory culture must be received within 8 hours of culture start. otherwise a new sample will be requested.
Additional Information
For BJH Laboratory Use Only
Minimum Volume: 0.5 mL