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One-day Workflow Scheme for Bacterial Pathogen Detection and Antimicrobial Resistance Testing from Blood Cultures

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Is the repeat worth it? Optimizing syndromic panel pathogen detection protocols.

Filipe M Cerqueira¹, Linh Do², Janet Enderle²

¹Department of Pathology, School of Health Professions, University of Texas Medical Branch, Galveston, TX, US.

Laboratory Medicine

|December 17, 2024

Summary

This summary is machine-generated.

A study comparing BioFire FilmArray gastrointestinal (GI) and respiratory (RP) panel retesting found that a 3-pathogen protocol did not improve patient outcomes but increased costs. The 4-pathogen protocol is recommended for cost-effectiveness.

Keywords:

cost analysis gastrointestinal panel laboratory testing molecular diagnostics repeat testing respiratory panel

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Area of Science:

Clinical diagnostics
Microbiology
Health economics

Background:

The BioFire FilmArray system is widely used for multiplex pathogen detection in gastrointestinal (GI) and respiratory (RP) infections.
Laboratory protocols for retesting positive panels vary, impacting cost and resource utilization.
Evaluating different retesting thresholds is crucial for optimizing diagnostic workflows.

Purpose of the Study:

To compare the cost-effectiveness and clinical impact of a 3-pathogen versus a 4-pathogen retesting protocol for BioFire FilmArray GI and RP panels.
To assess discrepancies and clinical outcomes associated with different retesting strategies.

Main Methods:

Analysis of 12,027 BioFire FilmArray GI and RP panels.
Comparison of a 3-pathogen retesting protocol against the manufacturer's 4-pathogen protocol.
Evaluation of retesting results, cost implications, and impact on antibiotic prescriptions and patient outcomes.

Main Results:

The 3-pathogen protocol showed identical results in 81% (GI) and 76% (RP) of retested panels.
Discrepancies were observed in 19% (GI) and 24% (RP) of panels.
The 3-pathogen protocol incurred an additional cost of $9820.32 without affecting antibiotic prescriptions or clinical outcomes.

Conclusions:

A stringent 3-pathogen retesting protocol for BioFire FilmArray panels does not enhance patient management compared to the 4-pathogen protocol.
The 3-pathogen protocol leads to unnecessary costs and potential kit shortages.
Adopting the manufacturer's 4-pathogen protocol is recommended to balance clinical rigor with cost-effectiveness in laboratory testing.