FilmArray GI Panel 上稀有病原体阳性结果的可重复性。
Reproducibility of positive results for rare pathogens on the FilmArray GI Panel.
机构信息
Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA; Clinical Microbiology Laboratory, Stanford Health Care, Stanford, CA, USA.
出版信息
Diagn Microbiol Infect Dis. 2019 Sep;95(1):10-14. doi: 10.1016/j.diagmicrobio.2019.03.013. Epub 2019 Mar 29.
Though the FilmArray GI Panel has a reported aggregate specificity and reproducibility of >97% and > 99%, respectively, the reproducibility is less understood in clinical practice. We measured the reproducibility of positive results for low-prevalence pathogens. Samples with positive results for selected targets were repeated using a different FilmArray module. Overall, 331 of 373 (89%) results were reproducible. Giardia lamblia (57/57, 100%), Cryptosporidium spp. (61/63, 97%), Cyclospora cayetanensis (34/35, 97%), Plesiomonas shigelloides (17/18, 94%), and Rotavirus A (76/77, 99%) were highly reproducible, while Adenovirus F40/41 (38/54, 70%), Vibrio spp. (8/10, 80%), V. cholerae (3/8, 37.5%), and Yersinia enterocolitica (36/50, 72%) were poorly reproducible. Review of 38 patients with nonreproducible results showed that 19 (50%) had evidence of gastroenteritis and only 6 (16%) had possible infection with the organism that showed a nonreproducible result. Higher false-positive rates with certain targets on FAGP emphasize the need for diagnostic stewardship.
虽然 FilmArray GI Panel 的综合特异性和重现性分别报告为>97%和>99%，但其在临床实践中的重现性了解较少。我们测量了低流行病原体阳性结果的重现性。使用不同的 FilmArray 模块对选定靶标阳性结果的样本进行重复检测。总体而言，373 个样本中有 331 个（89%）结果是可重现的。蓝氏贾第鞭毛虫（57/57，100%）、隐孢子虫属（61/63，97%）、环孢子虫属（34/35，97%）、类志贺邻单胞菌（17/18，94%）和轮状病毒 A（76/77，99%）的重现性很高，而腺病毒 F40/41（38/54，70%）、弧菌属（8/10，80%）、霍乱弧菌（3/8，37.5%）和小肠结肠炎耶尔森菌（36/50，72%）的重现性较差。对 38 例非重现性结果患者的回顾性研究表明，19 例（50%）有肠胃炎证据，只有 6 例（16%）可能感染了表现出非重现性结果的病原体。某些 FAGP 靶标出现较高的假阳性率，强调了诊断管理的必要性。
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