Practice Based Learning: Biofire FilmArray GI Panel in Acute Gastroenteritis

Jenny Lin MD

 

 

 

 

Presented by Jenny Lin MD (PGY1)

Clinical Question:

What is the utility of ordering a Biofire FilmArray GI PCR Panel for a case of acute gastroenteritis?

Biofire FilmArray GI PCR Panel:

  • Rapid multiplex PCR panel
  • 23 GI pathogens (bacteria, viruses, and protozoa)
  • 1 hour
  • $129 per test

Detects:

BioFire FilmArray Panel

How Useful is It?

How Useful is It?

*more than six unformed stools daily, fever, volume depletion requiring hospitalization, immunocompromised, >1 week, or blood, pus, or mucus in the stool

Takeaways:

  • The BioFire FilmArray GI PCR panel is extremely sensitive and specific, more than traditional testing.
  • Viral pathogens dominate in younger children < 5 years, in winter months, and with vomiting.
  • Bacterial pathogens are more likely in older children, summer months, and with diarrhea.
  • A bacterial etiology is more likely with multiple severe clinical factors.
  • If concerned for a protozoal etiology or a severe bacterial etiology, antimicrobial therapy or another change in management may be indicated.

References:

Stockmann C, et al. Detection of 23 Gastrointestinal Pathogens Among Children Who Present With Diarrhea. J Pediatric Infect Dis Soc. 2016 May 4. pii: piw020. [Epub ahead of print]

Buss SN, et al. Multicenter evaluation of the BioFire FilmArray gastrointestinal panel for etiologic diagnosis of infectious gastroenteritis. J Clin Microbiol. 2015 Mar;53(3):915-25.

Shim DH, Kim DY, Cho KY. Diagnostic value of the Vesikari Scoring System for predicting the viral or bacterial pathogens in pediatric gastroenteritis. Korean J Pediatr. 2016 Mar;59(3):126-31.

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