Detection rate of herpes simplex virus DNA in the lower respiratory tract of critical care patients with or without coinfection determined by the Biofire® pneumonia plus panel.

Abstract

We investigated whether the results returned by the Biofire® Pneumonia Plus Panel (FA-PP) in lower respiratory tract specimens (LRT) specimens may identify patients who should be targeted for Herpes simplex virus (HSV) DNA testing. We included 35 adult ICU patients who underwent protocolized HSV DNA testing in LRT and/or plasma specimens by real-time PCR. Of these, one patient underwent allogeneic hematopoietic cell transplantation, one a kidney transplantation and one was under CAR-T cell therapy. Twenty-three of the 33 patients (69.6 %) had HSV-type 1 (HSV-1) DNA detected in LRT specimens (median viral load: 5.67 log₁₀ copies/ml). Viral DNA was detected in 12/14 (85 %) plasma samples (median, 3.4 log₁₀ copies/ml) from patients with HSV-1 DNA present in LRT specimens. Patients testing positive by the FA-PP had a non-significant (P = 0.28) higher rate of HSV-1 DNA detection (10/13; 77 %) compared with patients returning negative results (9/16; 56 %). In conclusion, requests for HSV DNA testing in ICU patients should not depend on the results of conventional culture methods nor those provided by the FA-PP.