Department of Medical Microbiology & Radboudumc Center for Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands.
PLoS One. 2020 Feb 6;15(2):e0228596. doi: 10.1371/journal.pone.0228596. eCollection 2020.
Conventional routine PCR testing for gastrointestinal infections is generally based on pathogen related panels specifically requested by clinicians and can be erroneous and time consuming. The BioFire FilmArray gastrointestinal (GI) panel combines 22 pathogens into a single cartridge-based test on a random-access system, thereby reducing the turnaround time to less than 2 hours. We described the clinical impact of implementing the BioFire FilmArray on patients with gastroenteritis in our hospital.
Patients attending a Dutch tertiary care center (Radboud University Medical Center), from whom stool samples were obtained, were eligible for inclusion. The clinicians selected one or a combination of different routinely performed PCR panels (bacterial panel, viral panel, clostridium testing, and three parasitic panels) based on clinical history and symptoms. All samples were in parallel tested with the FilmArray. We retrospectively collected patient data regarding infection control and patient management to assess the potential impact of implementing the FilmArray.
In total 182 patients were included. Routine PCR detected one or more pathogens in 52 (28.6%) patients compared to 72 (39.6%) using the FilmArray. Turnaround time (including transport) decreased from median 53 hours for the routine PCR to 16 hours for the FilmArray. Twenty-six patients could have been removed from isolation 29 hours sooner, 3.6 antibiotic days could have been saved and in five patients additional imaging testing (including colonoscopies) could have been prevented.
The theoretical implementation of the BioFire FilmArray GI panel in patients with clinical suspicion of gastroenteritis resulted in a significant better patient management.
常规的胃肠道感染常规 PCR 检测通常基于临床医生特别要求的病原体相关面板,可能会出现错误且耗时。BioFire FilmArray 胃肠道(GI)面板将 22 种病原体组合到一个基于随机存取系统的单个试剂盒测试中,从而将周转时间缩短到不到 2 小时。我们描述了在我们医院实施 BioFire FilmArray 对肠胃炎患者的临床影响。
从荷兰三级护理中心(Radboud 大学医学中心)获得粪便样本的患者有资格入选。临床医生根据临床病史和症状选择一种或多种常规进行的 PCR 面板(细菌面板、病毒面板、梭菌检测和三个寄生虫面板)的组合。所有样本均与 FilmArray 并行测试。我们回顾性收集了有关感染控制和患者管理的患者数据,以评估实施 FilmArray 的潜在影响。
共纳入 182 例患者。与使用 FilmArray 的 72 例(39.6%)相比,常规 PCR 检测到 52 例(28.6%)患者中存在一种或多种病原体。周转时间(包括运输)从常规 PCR 的中位数 53 小时减少到 FilmArray 的 16 小时。26 例患者可以提前 29 小时解除隔离,节省 3.6 天抗生素治疗时间,5 例患者可以避免额外的影像学检查(包括结肠镜检查)。
在临床怀疑肠胃炎的患者中实施 BioFire FilmArray GI 面板的理论方法显著改善了患者管理。