Multiplex PCR Respiratory Panel in Indonesia: A Narrative Review

Abstract

Acute Respiratory infections (ARIs) remain a major cause of illness and death worldwide. Conventional diagnostic methods are often slow or have limited sensitivity. Multiplex (Polymerase Chain Reaction) PCR respiratory panels allow rapid detection of multiple respiratory pathogens from a single specimen and are increasingly available in Indonesia. This review summarizes the respiratory panels available in Indonesia and discusses their potential clinical use. A narrative review was conducted using literature from PubMed, manufacturer technical documents, and the Indonesian Ministry of Health medical device registry. Information on pathogen coverage, diagnostic performance, specimen requirements, and clinical applications was reviewed. There are six respiratory panel platforms currently available in Indonesia: VITRO Respiratory Flow Chip Kit, BioFire FilmArray Respiratory Panel 2.1 Plus, BioFire FilmArray Pneumonia Panel Plus, QIAstat-Dx Respiratory SARS-CoV-2 Panel, ALLPLEX Respiratory Panel, and COBAS Respiratory Flex. Most platforms focus on respiratory viruses and atypical bacteria using nasopharyngeal/oropharyngeal specimens, whereas BioFire FilmArray Pneumonia Panel Plus is designed for lower respiratory tract infections and additionally detects common bacterial pathogens, antimicrobial resistance genes, and provides semi-quantitative results. BioFire, QIAstat-Dx, and COBAS offer highly automated sample-to-answer workflows with minimal hands-on time, whereas VITRO and ALLPLEX require more manual processing but provide greater flexibility through open systems. Despite these advantages, implementation remains challenged by high costs and limited access in Indonesia. Six multiplex PCR respiratory panel platforms are available in Indonesia, each with different diagnostic characteristics and potential clinical applications. No single platform is optimal for all situations. Therefore, test selection should be tailored to the clinical setting, laboratory capacity, and available resources. Appropriate implementation may improve respiratory pathogen diagnosis and antimicrobial stewardship, although local evidence regarding clinical impact and cost-effectiveness is still needed.