Institute of Medical Microbiology and Infection Control, Goethe University Frankfurt, University Hospital, Frankfurt, Germany.
University Center for Infectious Diseases, Goethe University Frankfurt, University Hospital, Frankfurt, Germany.
J Med Microbiol. 2024 Feb;73(2). doi: 10.1099/jmm.0.001795.
Infectious gastroenteritis is a common reason for consulting a physician. Although most cases of gastrointestinal illness are self-limiting, the identification of the etiologic pathogen by stool specimen analysis is important in cases of more severe illness and for epidemiological reasons.Due to the broad range of causative pathogens, the conventional examination of a stool specimen is labour-intensive and usually requires different diagnostic methods. Multiplex PCR tests [e.g. BioFire Gastrointestinal (GI) Panel] allow the rapid detecting of up to 22 pathogens in one test. Using a multiplex PCR panel to test stool specimens for infectious gastroenteritis pathogens can improve the detection rate, reduce the time-to-result and hands-on time and lower the costs of a microbiology laboratory. This study was aimed at evaluating the detection rate, the workflow and associated costs of stool specimen management using the BioFire GI Panel versus conventional methods. Stool specimens were evaluated prospectively during the routine operation. Pathogen detection rate, hands-on time, time-to-result and material and personnel costs were determined for the BioFire GI Panel and conventional methods-the latter based on physician request and excluding viral testing. Analysing 333 specimens collected between 2019 and 2020, the detection rate of enteropathogens was significantly higher with a positivity rate of 39.9 % using the multiplex PCR panel compared with 15.0 % using the conventional methods. The BioFire GI Panel presented results in a median time of 2.2 h compared with 77.5 h for culture and 22.1 h for antigen testing, noting that no tests were performed at weekends except for toxinogenic . Based on list prices, the BioFire GI Panel was nine times more expensive compared with conventional methods, whereas hands-on-time was significantly lower using the BioFire GI Panel. Multiplex PCR panels are valuable tools for laboratory identification of infectious agents causing diarrhoea. The higher costs of such a multiplex PCR panel might be outweighed by the higher detection rate, ease of handling, rapid results and most likely improved patient management. However, these panels do not provide information on antimicrobial susceptibility testing. Therefore, if this is necessary for targeted therapy or if outbreak monitoring and control is required, specimens must still be cultured.
感染性胃肠炎是就诊医师的常见原因。虽然大多数胃肠道疾病是自限性的,但通过粪便标本分析确定病因病原体对于更严重的疾病和流行病学原因非常重要。由于致病病原体范围广泛,常规的粪便检查既费力,通常也需要不同的诊断方法。多重 PCR 检测(例如,BioFire 胃肠道 (GI) Panel)可在一次检测中快速检测多达 22 种病原体。使用多重 PCR 检测胃肠道感染性病原体可提高检测率,减少检测时间和操作时间,并降低微生物实验室的成本。本研究旨在评估使用 BioFire GI Panel 与传统方法检测粪便标本中感染性胃肠炎病原体的检测率、工作流程和相关成本。在常规操作期间前瞻性评估粪便标本。确定 BioFire GI Panel 和传统方法(基于医生要求,不包括病毒检测)的病原体检测率、操作时间、检测时间和材料及人员成本。分析 2019 年至 2020 年期间收集的 333 份标本,与传统方法(培养法的阳性率为 15.0%)相比,使用多重 PCR 检测的阳性率为 39.9%,肠病原体的检测率显著更高。使用 BioFire GI Panel 的中位结果时间为 2.2 小时,而培养法为 77.5 小时,抗原检测为 22.1 小时,请注意,周末除了产毒检测外,没有进行任何检测。基于目录价格,与传统方法相比,BioFire GI Panel 贵 9 倍,但使用 BioFire GI Panel 的操作时间明显更短。多重 PCR 检测对于实验室鉴定引起腹泻的感染因子是有价值的工具。如果这种多重 PCR 检测的高成本可以通过更高的检测率、易于操作、快速结果以及可能改善的患者管理来弥补,那么其成本可能是合理的。然而,这些检测不提供关于抗菌药物敏感性检测的信息。因此,如果需要靶向治疗或需要暴发监测和控制,则仍需要对标本进行培养。