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Comparative Study
. 2017 Dec 26;56(1):e01457-17.
doi: 10.1128/JCM.01457-17. Print 2018 Jan.

A Gastrointestinal PCR Panel Improves Clinical Management and Lowers Health Care Costs

Stacy G Beal  1 , Elizabeth E Tremblay  2 , Steven Toffel  3 , Lymaries Velez  3 , Kenneth H Rand  4   5
Affiliations
Comparative Study

A Gastrointestinal PCR Panel Improves Clinical Management and Lowers Health Care Costs

Stacy G Beal et al. J Clin Microbiol. .

Abstract

Conventional methods for the identification of gastrointestinal pathogens are time-consuming and expensive and have limited sensitivity. The aim of this study was to determine the clinical impact of a comprehensive molecular test, the BioFire FilmArray gastrointestinal (GI) panel, which tests for many of the most common agents of infectious diarrhea in approximately 1 h. Patients with stool cultures submitted were tested on the GI panel (n = 241) and were compared with control patients (n = 594) from the year prior. The most common organisms detected by the GI panel were enteropathogenic Escherichia coli (EPEC, n = 21), norovirus (n = 21), rotavirus (n = 15), sapovirus (n = 9), and Salmonella (n = 8). Patients tested on the GI panel had an average of 0.58 other infectious stool tests compared with 3.02 in the control group (P = 0.0001). The numbers of days on antibiotic(s) per patient were 1.73 in the cases and 2.12 in the controls (P = 0.06). Patients with the GI panel had 0.18 abdomen and/or pelvic imaging studies per patient compared with 0.39 (P = 0.0002) in the controls. The average length of time from stool culture collection to discharge was 3.4 days in the GI panel group versus 3.9 days in the controls (P = 0.04). The overall health care cost could have decreased by $293.61 per patient tested. The GI panel improved patient care by rapidly identifying a broad range of pathogens which may not have otherwise been detected, reducing the need for other diagnostic tests, reducing unnecessary use of antibiotics, and leading to a reduction in hospital length of stay.

Keywords: PCR; clinical management; diarrhea; gastroenteritis; gastrointestinal infection; molecular panel; norovirus; salmonella; syndromic testing.

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Figures

FIG 1
FIG 1
Distribution of organisms identified on the GI panel for adult and pediatric patients. A total of 241 samples were tested, and 79 (32.8%) were positive for a total of 103 organisms. Absolute numbers and percentages of positive tests within each age group are shown.
See this image and copyright information in PMC

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