FilmArray GI panel performance for the diagnosis of acute gastroenteritis or hemorragic diarrhea

A. Piralla, G. Lunghi, G. Ardissino, A. Girello, M. Premoli, E. Bava, M. Arghittu, M. R. Colombo, A. Cognetto, P. Bono, G. Campanini, P. Marone, F. Baldanti

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Acute gastroenteritis is a common cause of morbidity and mortality in humans worldwide. The rapid and specific identification of infectious agents is crucial for correct patient management. However, diagnosis of acute gastroenteritis is usually performed with diagnostic panels that include only a few pathogens. In the present bicentric study, the diagnostic value of FilmArray GI panels was assessed in unformed stool samples of patients with acute gastroenteritis and in a series of samples collected from pediatric patients with heamorragic diarrhea. The clinical performance of the FilmArray gastrointestinal (GI) panel was assessed in 168 stool samples collected from patients with either acute gastroenteritis or hemorragic diarrhea. Samples showing discordant results between FilmArray and routine methods were further analyzed with an additional assay. RESULTS: Overall, the FilmArray GI panel detected at least one potential pathogen in 92/168 (54.8%) specimens. In 66/92 (71.8%) samples, only one pathogen was detected, while in 26/92 (28.2%) multiple pathogens were detected. The most frequent pathogens were rotavirus 13.9% (22/168), Campylobacter 10.7% (18/168), Clostridium difficile 9.5% (16/168), and norovirus 8.9% (15/168). Clostridium difficile was identified only in patients with acute gastroenteritis (p <0.01), while STEC was detected exclusively in patients with hemorragic diarrhea (p <0.01). In addition, Campylobacter spp., Salmonella spp., EPEC and E. coli producing Shiga-like toxin were more frequently detected in patients with hemorragic diarrhea (p <0.05). The overall percent agreement calculated in samples was 73.8% and 65.5%, while 34.5% were discordant. After additional confirmatory analyses, the proportion of discordant samples decreased to 7.7%. Rotavirus and astrovirus were the most frequently unconfirmed pathogens. CONCLUSION: In conclusion, the FilmArray GI panel has proved to be a valuable new diagnostic tool for improving the diagnostic efficiency of GI pathogens.
Original languageEnglish
Pages (from-to)111-017-1018-2
JournalBMC Microbiology
Volume17
Issue number1
DOIs
Publication statusPublished - May 12 2017

Keywords

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteria/isolation & purification/pathogenicity
  • Bacterial Infections/diagnosis/microbiology
  • Campylobacter/isolation & purification/pathogenicity
  • Child
  • Child, Preschool
  • Clostridium difficile/isolation & purification/pathogenicity
  • Diarrhea/diagnosis/microbiology/virology
  • Escherichia coli/isolation & purification/pathogenicity
  • Female
  • Gastroenteritis/diagnosis/microbiology/virology
  • Hemorrhage
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Molecular Diagnostic Techniques/instrumentation/methods
  • Multiplex Polymerase Chain Reaction/methods
  • Rotavirus/isolation & purification/pathogenicity
  • Sensitivity and Specificity
  • Virus Diseases/diagnosis/virology
  • Viruses/isolation & purification/pathogenicity
  • Young Adult
  • Acute gastroenteritis
  • FilmArray
  • Hemorragic diarrhea
  • Multiplex PCR

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