Detection of Causative Agents of Acute Upper Respiratory Tract Infection by Film Array Respiratory Panel at Point of Care in a Tertiary Care Hospital

Acute respiratory tract infections are the most prevalent illnesses in individuals of all age groups and are a significant contributor to hospitalization, morbidity, and mortality. In cases of severe infections, it is vital to quickly diagnose these infections for effective management. This study rapidly detected the causative organism of acute upper respiratory tract infection using the Film Array Respiratory Panel 2.1 plus (FARP). It was a cross-sectional study, where N=471 nasopharyngeal swab specimens were collected from suspected patients with acute upper respiratory tract infections attending the outpatient department (OPD) of the Bangladesh Institute of Tropical and Infectious Diseases (BITID). The specimens were tested with the FARP 2.1 plus, an automated multiplex PCR assay that detects 23 targets, including 19 viruses and 4 bacteria respectively. A total of 471 samples were tested by FARP 2.1 plus, and we found a notable 71% (333/471) were positive for either single (60%) or multiple (11%) pathogens. Influenza B virus (22.9%) was the most prevalent, followed by influenza A (20.2%), Human Rhino/Entero (11.3%), respiratory syncytial virus (8.1%), and SARS-COV-2 (5.2%). Influenza virus (Flu) and SARS-CoV-2 had a significant impact in single infection (P values <0.0001 and 0.0397), where Adeno virus and Bordetella pertussis had a significant impact in coinfection (P values <0.0001 and 0.001). Among the co-infections, SARS-CoV-2 and Influenza B virus (12%) were the most common, where 42% of the time was Human Rhino/Entero. The prevalence of organisms differed by age, and influenza viruses (A or B) were most common in all age groups, as in Bangladesh, the influenza virus is mostly involved in respiratory tract infections. Film Array Respiratory Panel 2.1 Plus allows the rapid simultaneous detection of a wide number of respiratory organisms, with limited hands-on time in patients with acute upper respiratory tract infection.