title: Evaluation of the BioFire FilmArray® GastrointestinalPanel in a Midwestern Academic Hospital.
abstract: The BioFire FilmArray® Gastrointestinal Panel (GIP) was implemented to replace traditional stool culture and enzyme immunoassay (EIA) testing for stool pathogens. The purpose of this study was to evaluate the detection rate, incidence of coinfection, and culture recovery rate of gastrointestinal (GI) pathogens detected by the GIP over a 1-year period. A total of 2257 stools collected from January to December 2015 were tested using the GIP. Clostridium difficile colonization was also evaluated by an antigen/toxin EIA and confirmatory polymerase chain reaction (PCR). The GIP detected one pathogen in 911 (40.4%) specimens. Coinfections were detected in 176 (7.8%) of these specimens. The most frequently detected pathogens were C. difficile (15.2%), norovirus (8.9%), enteropathogenic Escherichia coli (7.1%), enteroaggregative E. coli (3.4%), Campylobacter spp. (2.3%), and sapovirus (2.0%). Each of the remaining GIP targets had a detection rate of ≤1.6%. The recovery of bacteria for public health investigations varied, with rates as high as 77% for Salmonella to as low as 30% for Yersinia enterocolitica. Of stools positive for C. difficile on the GIP that were tested by EIA, only 42.7% (88/206) were found to be producing detectable toxin. Overall, the implementation of the GIP resulted in high detection rates of GI pathogens, including the frequent detection of coinfections. This is a promising test to streamline the testing of agents causing infectious gastroenteritis from multiple tests down to a single order with limited hands-on time. Ongoing studies will need to assess the impact that the GIP has on downstream patient care and public health practices.
authors.affiliation: Department of Pathology and Microbiology, University of Nebraska Medical Center, 985900 Nebraska Medical Center, Omaha, NE, 68198-5900, USA. caitlin.murphy@unmc.edu.
authors.forename: C N
authors.initials: CN
authors.lastname: Murphy
authors.affiliation: Department of Pathology and Microbiology, University of Nebraska Medical Center, 985900 Nebraska Medical Center, Omaha, NE, 68198-5900, USA.
authors.forename: R C
authors.initials: RC
authors.lastname: Fowler
authors.affiliation: Department of Pathology and Microbiology, University of Nebraska Medical Center, 985900 Nebraska Medical Center, Omaha, NE, 68198-5900, USA.|Nebraska Public Health Laboratory, University of Nebraska Medical Center, Omaha, NE, 68198-5900, USA.
authors.forename: P C
authors.initials: PC
authors.lastname: Iwen
authors.affiliation: Department of Pathology and Microbiology, University of Nebraska Medical Center, 985900 Nebraska Medical Center, Omaha, NE, 68198-5900, USA.
authors.forename: P D
authors.initials: PD
authors.lastname: Fey
mesh_terms: D000046:Academic Medical Centers; D001424:Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology; D060085:Coinfection / Q000175:diagnosis* / Q000382:microbiology / Q000821:virology; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005759:Gastroenteritis / Q000175:diagnosis* / Q000382:microbiology / Q000821:virology; D006761:Hospitals; D006801:Humans; D008828:Microbiological Techniques / Q000379:methods*; D015146:Midwestern United States; D014777:Virus Diseases / Q000175:diagnosis* / Q000821:virology