Filmarray在儿童社区获得性肺炎中的应用价值

• 作 者: 王东
• 机 构: 上海交通大学医学院附属上海儿童医学中心呼吸科 200127
• 出 处: 国际儿科学杂志
• 发表日期: 2021年10期
• 关键词: Community acquired pneumonia Filmarray Rapid detection of pathogens Clinical val

Filmarray作为一种多重聚合酶链式反应(polymerase chain reaction，PCR)病原检测体系，具有通量高、阳性率高等特点，该文评价了Filmarray在儿童社区获得性肺炎(community acquired pneumonia，CAP)中的病原检测性能、临床价值和经济学价值。支气管肺泡灌洗液(bronchoalveolar lavage fluid，BALF)是用于Filmarray呼吸道病原检测较好的样本类型。Filmarray呼吸检测体系(Filmarray respiratory panel，FARP)可作为CAP中常规检测方法阴性时病原体补充检测手段之一，可提供重症CAP患儿更多的病原信息，可为重症CAP提供“早期病原预警”信号，可能对重症CAP或重症CAP转化倾向的患儿更加适用。Filmarray肺炎检测体系(Filmarray pneumonia panel，FAPP)在重症CAP早期或者病情加重时提供快速的病原结果和耐药基因结果辅助指导抗生素针对性的使用，有望发挥一定的抗生素管理潜力。FARP和FAPP的结果需要医生综合患儿临床特征进行判读，评价两种检测体系中的临床指标和经济学价值，需严格控制混杂因素。“,”As a multiplex PCR pathogen detection system, Filmarray has the characteristics of high flux and high positive rate.This paper evaluates the pathogen detection performance, clinical value and economic value of Filmarray in children with community acquired pneumonia.Bronchoalveolar lavage fluid is a good respiratory sample type for Filmarray in pathogen detection.Filmarray respiratory panel(FARP)can be used as one of the supplementary detection methods for pathogens in CAP when the conventional ways is negative.Not only it can provide more pathogenic information of children with severe CAP, but also provide early pathogen warning signals for severe CAP.Furthermore, it may be more suitable for severe CAP or children with severe CAP transformation tendency.Filmarray pneumonia panel(FAPP)provides rapid respiratory pathogen results and drug-resistant gene results to assist in the targeted use of antibiotics in the early stage of severe CAP or when the condition worsens, which is expected to play a certain antibiotic management potential.The results of FARP and FAPP need to be interpreted by doctor based on the clinical characteristics of the children.Confounding factors need to be strictly controlled in the evaluation of different clinical indicators and economic value of the two detection systems.