Document Type
Article
Abstract
Objective: 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. Methods: 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. 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). Conclusion: Stewardship opportunities exist to optimize the diagnostic application of the GI multiplex PCR panel.
Digital Object Identifier (DOI)
Publication Info
Published in Therapeutic Advances in Infectious Disease, Volume 7, 2020, pages 2049936120959561-.
Rights
https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
APA Citation
O’Neal, M., Murray, H., Dash, S., Al-Hasan, M., Justo, J., & Bookstaver, P. (2020). Evaluating appropriateness and diagnostic stewardship opportunities of multiplex polymerase chain reaction gastrointestinal testing within a hospital system. Therapeutic Advances In Infectious Disease, 7, 204993612095956. https://doi.org/10.1177/2049936120959561