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Multiplex gastrointestinal pathogen panels: implications for infection control

Kenneth H Rand1, Elizabeth E Tremblay2, Mari Hoidal3

  • 1Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL 32610.

Diagnostic Microbiology and Infectious Disease
|March 23, 2015
PubMed

Insights

Molecular testing for gastrointestinal (GI) infections in hospitalized patients identified other pathogens in 22.2% of cases, impacting isolation decisions. Multiplex GI panels can improve patient isolation protocols and reduce healthcare-associated infections.

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Hospital Epidemiology

Background:

  • Diarrhea in acute care hospitals has diverse causes, both infectious and noninfectious.
  • Current Centers for Disease Control and Prevention (CDC) guidelines recommend contact precautions for infectious diarrhea, but reliable molecular diagnostics are needed to identify causative agents.
  • Accurate diagnosis is crucial for appropriate patient isolation and preventing the spread of infections within healthcare settings.

Purpose of the Study:

  • To evaluate the utility of the FilmArray GI Panel in identifying infectious agents in inpatient diarrheal stool specimens.
  • To assess the impact of molecular diagnostic results on patient isolation decisions and potential nosocomial transmission.
  • To determine the proportion of patients who were incorrectly isolated or could have been removed from isolation based on multiplex GI panel testing.

Main Methods:

  • Retrospective analysis of 158 inpatient diarrheal stool specimens previously tested negative for Clostridium difficile and/or rotavirus.
  • Use of the FilmArray GI Panel (BioFire Diagnostics) for multiplex detection of a wide range of gastrointestinal pathogens.
  • Review of patient isolation status and duration based on conventional testing versus FilmArray GI Panel results.

Main Results:

  • The FilmArray GI Panel detected at least one additional infectious agent in 22.2% of the tested specimens.
  • Of the patients with a positive GI panel result, 60% were never placed in appropriate isolation, contributing to 109 patient-days of potential transmission.
  • Conversely, 20.3% of patients with negative GI panel results could have been removed from isolation, optimizing resource utilization.

Conclusions:

  • Multiplex gastrointestinal panels significantly improve the identification of infectious diarrhea agents in hospitalized patients.
  • Utilizing these molecular assays can lead to more accurate patient isolation decisions, reducing both under-isolation and over-isolation.
  • Implementation of multiplex GI panels has the potential to decrease nosocomial transmission of infectious gastroenteritis agents.
Keywords:
GI panelInfection controlNorovirus

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