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A Gastrointestinal PCR Panel Improves Clinical Management and Lowers Health Care Costs
Stacy G Beal1, Elizabeth E Tremblay2, Steven Toffel3
1Department of Pathology, Immunology, & Laboratory Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA StacyGBeal@ufl.edu.
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.
Insights
The BioFire FilmArray gastrointestinal (GI) panel rapidly identifies infectious diarrhea pathogens, improving patient care by reducing diagnostic tests, antibiotic use, and hospital stays.
Area of Science:
- Clinical microbiology
- Infectious diseases
- Molecular diagnostics
Background:
- Conventional gastrointestinal pathogen identification methods are slow, costly, and lack sensitivity.
- Rapid and accurate diagnosis of infectious diarrhea is crucial for effective patient management.
Purpose of the Study:
- To evaluate the clinical impact of the BioFire FilmArray gastrointestinal (GI) panel for diagnosing infectious diarrhea.
- To compare the efficiency and outcomes of the GI panel test against traditional methods.
Main Methods:
- A prospective study comparing patients tested with the GI panel (n=241) to historical controls (n=594).
- Analysis of diagnostic test utilization, antibiotic use, imaging studies, and length of hospital stay.
Main Results:
- The GI panel identified common pathogens like EPEC, norovirus, rotavirus, sapovirus, and Salmonella.
- Patients tested with the GI panel underwent fewer additional stool tests (0.58 vs 3.02) and imaging studies (0.18 vs 0.39).
- A trend towards reduced antibiotic use (1.73 vs 2.12 days) and a shorter hospital stay (3.4 vs 3.9 days) was observed.
Conclusions:
- The BioFire FilmArray GI panel significantly enhances patient care by enabling rapid, broad-range pathogen detection.
- This molecular test reduces the need for supplementary diagnostics, optimizes antibiotic stewardship, and shortens hospitalizations, potentially lowering healthcare costs.
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