2191. The Sputum FilmArray Pneumonia Panel (SFAPP) Outperforms a Diagnostic Bundle in Patients with Community-Acquired Pneumonia (CAP)

BACKGROUND: This study compares the detection of respiratory pathogens between a multitest “Bundle” (MTB) and the Sputum FilmArray Pneumonia Panel (SFAPP). METHODS: Patients admitted from the ED with CAP were enrolled. The SFAPP probed for the presence of 18 bacterial species and 17 viral targets. The results were compared with pathogen detection with an MTB: (a) culture of sputum and blood; (b) urine antigens of S. pneumoniae and Legionella pneumophila; (c) Nasopharyngeal (NP) Respiratory FilmArray (NPRFA) panel which detects 17 viruses and 3 bacteria; and (d) nasal NAATs for S. pneumoniae and S. aureus. Two serum procalcitonin (PCT) levels helped separate bacterial colonization from invasion. RESULTS: Of 400 enrolled patients, 121 (30%) were non-evaluable due to a lack of a sputum specimen, 72 (18%) with a final diagnosis other than CAP, and other reasons in 21 (5%). Herein, the results of 186 (47%) evaluable patients with CAP and the Pneumonia Severity Index values of over 90 in 64.5%. The SFAPP detected viruses in 114/186 (61.3%) patients compared with 73/186 (39.2%) with the NPRFAP, p. The SFAPP detected bacterial pathogen(s) in 140/186 (75.3%) of patients vs. 117/183 (62.9%) with the MTB, pH. influenzae, M. catarrhalis, and S. agalactiae, p. A potential pathogenic bacteria and/or virus was detected in 176 of the 186 (95%) evaluable patients. Patients were classified as: virus detected (22); bacteria detected (57); bacteria and virus (97); CAP but no pathogen detected (10). The distribution of serum PCT levels by pathogen detected is shown in Figure 1. The dashed line is the 0.25 ng/mL “cut-off” to help separate colonization from invasion by bacteria. Antibiotic use was less in influenza patients with low PCT levels, p. In 22 patients with only virus detected and PCT. CONCLUSION: The Sputum FilmArray Pneumonia Panel detected more bacteria and viral potential pathogens than the Multitest Bundle that included the Nasopharyngeal FilmArray Panel. The Sputum FilmArray Pneumonia Panel may allow removal of nasopharyngeal swabs and urine antigens from the MTB. [Image: see text] DISCLOSURES: All authors: No reported disclosures.