O'Neal Melissa, Murray Hanna, Dash Sangita, Al-Hasan Majdi N, Justo Julie Ann, Bookstaver P Brandon
University of South Carolina College of Pharmacy, 715 Sumter Street, Columbia, SC 29208, USA.
University of South Carolina College of Pharmacy, Columbia, SC, USA.
Ther Adv Infect Dis. 2020 Sep 22;7:2049936120959561. doi: 10.1177/2049936120959561. eCollection 2020 Jan-Dec.
This single-center, retrospective, observational cohort study evaluates the appropriateness of the BioFire® FilmArray® Gastrointestinal (GI) multiplex PCR panel testing at a community-teaching hospital.
All adult, hospitalized patients at Prisma Health Richland Hospital with a documented GI multiplex PCR panel from 1 April 2015 through 28 February 2018 were included in the analysis. Inappropriate use of the GI panel was defined as a test obtained without documented diarrhea, greater than 2 days of hospitalization, redundant use with other diagnostic tests (e.g. PCR), or laxative use in the preceding 48 h. Antibiotic use and host variables were compared between groups with positive and negative results.
During the study period, 442 GI panels were obtained, among which 268 (61%) were deemed inappropriate. Primary reasons for inappropriate testing were lack of documented diarrhea ( = 92), greater than 2 days of hospitalization ( = 116), having a duplicate PCR test ordered ( = 118), or laxative use in the 48 h before testing ( = 36). A total of 141 (32%) GI panels were positive. The most frequently identified pathogens were (51.1%, = 72), Enteropathogenic (17.7%, = 25), and Norovirus GI/GII (12.1%, = 17). Patients with negative GI panel results were initiated on antibiotics significantly less frequently than those with positive GI panels (62.5% 80.2%, < 0.00001).
Stewardship opportunities exist to optimize the diagnostic application of the GI multiplex PCR panel.
本单中心、回顾性观察队列研究评估了BioFire® FilmArray® 胃肠道（GI）多重PCR检测板在一家社区教学医院使用的适宜性。
分析2015年4月1日至2018年2月28日期间在Prisma Health Richland医院住院且有记录的接受GI多重PCR检测板检测的所有成年患者。GI检测板的不当使用定义为在无腹泻记录的情况下进行检测、住院超过2天、与其他诊断检测（如PCR）重复使用或在检测前48小时内使用泻药。比较了检测结果为阳性和阴性的两组患者的抗生素使用情况和宿主变量。
在研究期间，共进行了442次GI检测板检测，其中268次（61%）被认为是不当的。不当检测的主要原因是缺乏腹泻记录（n = 92）、住院超过2天（n = 116）、已订购重复的PCR检测（n = 118）或在检测前48小时内使用泻药（n = 36）。共有141次（32%）GI检测板检测结果为阳性。最常鉴定出的病原体是艰难梭菌（51.1%，n = 72）、致病性大肠杆菌（17.7%，n = 25）和诺如病毒GI/GII（12.1%，n = 17）。GI检测板检测结果为阴性的患者开始使用抗生素的频率明显低于检测结果为阳性的患者（62.5%对80.2%，P < 0.00001）。
存在优化GI多重PCR检测板诊断应用的管理机会。
