Abstract
ObjectivesConventional routine PCR testing for gastrointestinal infections is generally based on pathogen related panels specifically requested by clinicians and can be erroneous and time consuming. The BioFire FilmArray gastrointestinal (GI) panel combines 22 pathogens into a single cartridge-based test on a random-access system, thereby reducing the turnaround time to less than 2 hours. We described the clinical impact of implementing the BioFire FilmArray on patients with gastroenteritis in our hospital.MethodsPatients attending a Dutch tertiary care center (Radboud University Medical Center), from whom stool samples were obtained, were eligible for inclusion. The clinicians selected one or a combination of different routinely performed PCR panels (bacterial panel, viral panel, clostridium testing, and three parasitic panels) based on clinical history and symptoms. All samples were in parallel tested with the FilmArray. We retrospectively collected patient data regarding infection control and patient management to assess the potential impact of implementing the FilmArray.ResultsIn total 182 patients were included. Routine PCR detected one or more pathogens in 52 (28.6%) patients compared to 72 (39.6%) using the FilmArray. Turnaround time (including transport) decreased from median 53 hours for the routine PCR to 16 hours for the FilmArray. Twenty-six patients could have been removed from isolation 29 hours sooner, 3.6 antibiotic days could have been saved and in five patients additional imaging testing (including colonoscopies) could have been prevented.ConclusionThe theoretical implementation of the BioFire FilmArray GI panel in patients with clinical suspicion of gastroenteritis resulted in a significant better patient management.
Highlights
Diarrhea is a common cause of morbidity and hospital admission
The theoretical implementation of the BioFire FilmArray GI panel in patients with clinical suspicion of gastroenteritis resulted in a significant better patient management
In this study we evaluated the potential impact of rapid microbial diagnosis in gastrointestinal disease on infection control and patient care
Summary
In the Netherlands, the annual incidence of gastrointestinal (GI) infection is estimated to be 4.5 million episodes with an estimated cost of 611–695 million euro.[1, 2] Admitted patients with symptoms of gastroenteritis (diarrhea, vomiting) are isolated until the result of the diagnostic test is known or another, non-infectious, cause has been identified. The diagnosis of infectious gastroenteritis is generally driven by pathogen directed molecular panels. These panels are pathogen specific and based on expected bacterial, viral or parasitic causes. Depending on the laboratory routine, turn-around times of one or more days is common practice, during which a patient is isolated with empirical therapy or no therapy at all.[8]
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