A Gastrointestinal PCR Panel Improves Clinical Management and Lowers Health Care Costs

Abstract

Conventional methods for the identification of gastrointestinal pathogens are time-consuming and expensive and have limited sensitivity. The aim of this study was to determine the clinical impact of a comprehensive molecular test, the BioFire FilmArray gastrointestinal (GI) panel, which tests for many of the most common agents of infectious diarrhea in approximately 1 h. Patients with stool cultures submitted were tested on the GI panel (<i>n</i> = 241) and were compared with control patients (<i>n</i> = 594) from the year prior. The most common organisms detected by the GI panel were enteropathogenic <i>Escherichia coli</i> (EPEC, <i>n</i> = 21), norovirus (<i>n</i> = 21), rotavirus (<i>n</i> = 15), sapovirus (<i>n</i> = 9), and <i>Salmonella</i> (<i>n</i> = 8). Patients tested on the GI panel had an average of 0.58 other infectious stool tests compared with 3.02 in the control group (<i>P</i> = 0.0001). The numbers of days on antibiotic(s) per patient were 1.73 in the cases and 2.12 in the controls (<i>P</i> = 0.06). Patients with the GI panel had 0.18 abdomen and/or pelvic imaging studies per patient compared with 0.39 (<i>P</i> = 0.0002) in the controls. The average length of time from stool culture collection to discharge was 3.4 days in the GI panel group versus 3.9 days in the controls (<i>P</i> = 0.04). The overall health care cost could have decreased by $293.61 per patient tested. The GI panel improved patient care by rapidly identifying a broad range of pathogens which may not have otherwise been detected, reducing the need for other diagnostic tests, reducing unnecessary use of antibiotics, and leading to a reduction in hospital length of stay.