{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:14:18Z","timestamp":1777853658190,"version":"3.51.4"},"reference-count":11,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Infective pneumonia is a major cause of respiratory failure and ICU admission, but non-infectious mimics\u2014such as autoimmune disease, malignancy, and organizing pneumonia\u2014are also common. Multiplex PCR pneumonia panels may help differentiate these entities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective before-and-after study (1 Jan 2024-30 Jun 2025) evaluating the FilmArray Pneumonia plus panel (FAPN) in adults with respiratory failure admitted to two district general hospital ICUs. Consecutive patients undergoing FAPN testing (n\u2009=\u2009116) were included. In the post-intervention cohort (n\u2009=\u200956), a consensus panel determined the cause of respiratory failure in patients with suspected pneumonia (PF ratio &lt;300\u2005mm\u2009Hg and \u22651 radiographic quadrant involvement). Agreement between FAPN and sputum culture\u2014including the diagnostic value of a negative FAPN\u2014was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among post-intervention patients with suspected pneumonia (n\u2009=\u200945), the combined finding of \u201cnegative FAPN and negative sputum culture\u201d identified non-infectious mimics with a sensitivity of 75% (95% CI 50-100%) and specificity of 91% (95% CI 81-100%). In multivariable analysis, negative FAPN results were associated with reduced antibiotic escalation (OR 0.70;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.01). The positive predictive value of individual FAPN bacterial targets ranged from 0%\u2013100% (median 35%). Culture confirmation increased with higher FAPN quantitative bins: 8% at 10\n                      <jats:sup>4<\/jats:sup>\n                      \u2005CFU\/mL, 7% at 10\n                      <jats:sup>5<\/jats:sup>\n                      \u2005CFU\/mL, 48% at 10\n                      <jats:sup>6<\/jats:sup>\n                      \u2005CFU\/mL, and 57% at 10\n                      <jats:sup>7<\/jats:sup>\n                      \u2005CFU\/mL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In ICU patients with suspected pneumonia, a combined negative FAPN and sputum culture result should prompt evaluation for non-infectious mimics. Negative FAPN findings may help reduce unnecessary antibiotic escalation, although their positive predictive value for culture-confirmed bacterial infection is limited.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08850666261442190","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T14:14:12Z","timestamp":1776694452000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prospective Multicenter Evaluation of a multiplex PCR Pneumonia Panel to Distinguish Infectious Pneumonia from Non-Infectious Mimics in ICU Respiratory Failure"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9627-4468","authenticated-orcid":false,"given":"Lap Tin","family":"Ho","sequence":"first","affiliation":[{"name":"North District Hospital"},{"name":"Chinese University of Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2161-1420","authenticated-orcid":false,"given":"Alfred Lok Hang","family":"Lee","sequence":"additional","affiliation":[{"name":"Prince of Wales Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chin Wing","family":"Yu","sequence":"additional","affiliation":[{"name":"North District Hospital"},{"name":"North District Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5036-1707","authenticated-orcid":false,"given":"Eddie Chi Man","family":"Leung","sequence":"additional","affiliation":[{"name":"Prince of Wales Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Man Ting","family":"Yuk","sequence":"additional","affiliation":[{"name":"Prince of Wales Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas Yuk Bun","family":"Lau","sequence":"additional","affiliation":[{"name":"North District Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid Yu Ying","family":"Cheung","sequence":"additional","affiliation":[{"name":"Prince of Wales Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0897-869X","authenticated-orcid":false,"given":"Viola Chi Ying","family":"Chow","sequence":"additional","affiliation":[{"name":"Prince of Wales Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3025-5196","authenticated-orcid":false,"given":"Duncan Ka Hing","family":"Lam","sequence":"additional","affiliation":[{"name":"Alice Ho Miu Ling Nethersole Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip Koon Ngai","family":"Lam","sequence":"additional","affiliation":[{"name":"North District Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6705-6004","authenticated-orcid":false,"given":"Kwok Ming","family":"Ho","sequence":"additional","affiliation":[{"name":"Chinese University of Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2003.12.006"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41479-016-0002-1"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/2049936112469017"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-025-07903-3"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-024-07772-2"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(24)00170-8"},{"key":"e_1_3_3_8_2","article-title":"Combined use of a multiplex PCR and serum procalcitonin to reduce antibiotic exposure in critically ill patients with community-acquired pneumonia: the MULTI-CAP randomized controlled trial","author":"Voiriot G","unstructured":"Voiriot G, Argaud L, Cohen Y, et al. Combined use of a multiplex PCR and serum procalcitonin to reduce antibiotic exposure in critically ill patients with community-acquired pneumonia: the MULTI-CAP randomized controlled trial. Intensive Care Med. 2025;51(8):1417-1430.","journal-title":"Intensive Care Med"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-022-02086-7"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab1034"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00135-20"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiad221"}],"container-title":["Journal of Intensive Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08850666261442190","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08850666261442190","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08850666261442190","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:55:33Z","timestamp":1777503333000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08850666261442190"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,20]]},"references-count":11,"alternative-id":["10.1177\/08850666261442190"],"URL":"https:\/\/doi.org\/10.1177\/08850666261442190","relation":{},"ISSN":["0885-0666","1525-1489"],"issn-type":[{"value":"0885-0666","type":"print"},{"value":"1525-1489","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,20]]},"article-number":"08850666261442190"}}