Use of BIOFIRE® Pneumonia Panel Plus on sputum from patients with Cystic fibrosis or PCD

<b>Background:</b> PCD and Cystic fibrosis are associated with chronic pulmonary infections. Pseudomonas aeruginosa (PA) or S. aureus (SA) cause a decline of lung function and determine antibiotic therapy. Viral infections influence onset of CF exacerbation. The BIOFIRE® Pneumonia Panel Plus comprises semiquantitative detection of 15 bacteria, 7 antibiotic resistance markers and 9 viruses. <b>Aims:</b> Can Biofire® POCT contribute to the early detection of CF-pathogens? We hypothesized a sensitive detection of PA and SA species as well as viral coinfections. <b>Methods:</b> From July - December 2019 sputum samples from in- or outpatients with CF or PCD were collected. Basic demographic and clinical data were obtained. Each sputum sample underwent Biofire® Pneumonia Panel Plus and culture-based testing. <b>Results:</b> 17 out- and 10 inpatients’ sputum samples were tested. 78% (21/27) had already received antibiotic treatment. POCT Biofire® detected viral coinfection in 8 cases. 19 samples were culture positive for PA, of which only 14 were detected by POCT. 17 were culture-positive for SA, of which 16 were detected by POCT. In 7 cases antibiotic resistance markers (mecA/C, MREJ) were found. The mean duration obtaining culture results was 9 days. <b>Method:</b> The POCT Biofire® showed ambiguous results detecting CF-pathogens. Concordance rate for PA was substantial and for SA good, according to Cohen’s kappa. The sensitivity of 73.7 % for PA might be due to false-negative classification when pathogens’ copies are quantified &lt; 10^4/ml. The extended period to obtain culture results poses a limitation in clinical routine. POCT tools can be valuable screening for MRSA or viral coinfections.