Rand Kenneth H, Tremblay Elizabeth E, Hoidal Mari, Fisher Lori B, Grau Katrina R, Karst Stephanie M
Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL 32610.
UF Health Shands Hospital Department of Infection Control and Prevention, Gainesville, FL 32610.
Diagn Microbiol Infect Dis. 2015 Jun;82(2):154-7. doi: 10.1016/j.diagmicrobio.2015.01.007. Epub 2015 Jan 22.
In the acute care hospital inpatient setting, there is a wide variety of causes for both infectious and noninfectious diarrhea. However, without molecular assays for the wide range of agents causing gastroenteritis, there is no reliable way to determine which individuals should be placed in contact precautions, as recommended by CDC. We tested 158 inpatient diarrheal stool specimens with the FilmArray GI Panel (BioFire Diagnostics, Salt Lake City, UT, USA) that had been stored at -70°C after testing negative by conventional methods for Clostridium difficile and/or rotavirus. We found that 22.2% had at least 1 other infectious agent detected, and 60% of these patients were never placed in appropriate isolation for a total of 109 patient-days. In addition, 20.3% of patients with negative GI panel results could have been removed from isolation. Use of multiplex gastrointestinal panels may improve decisions regarding patient isolation and reduce nosocomial transmission.
在急性护理医院的住院环境中，感染性和非感染性腹泻有多种病因。然而，由于缺乏针对引起肠胃炎的多种病原体的分子检测方法，因此没有可靠的方法来确定哪些个体应按照美国疾病控制与预防中心（CDC）的建议采取接触预防措施。我们使用FilmArray胃肠道检测板（BioFire Diagnostics公司，美国犹他州盐湖城）对158份住院腹泻粪便标本进行了检测，这些标本在通过传统方法检测艰难梭菌和/或轮状病毒呈阴性后，一直保存在-70°C。我们发现，22.2%的标本至少检测到1种其他感染病原体，其中60%的患者从未进行过适当隔离，总计109个患者日。此外，胃肠道检测板结果为阴性的患者中有20.3%本可解除隔离。使用多重胃肠道检测板可能会改善关于患者隔离的决策，并减少医院内传播。
