211. Rate of Detection of Multiple Organisms with Multiplex PCR Gastrointestinal Panel in Pediatrics
Session: Poster Abstract Session: Diagnostics: Enteric Infection
Thursday, October 27, 2016
Room: Poster Hall
  • Saisho Mangla Final Poster IDWeek 2016.pdf (666.0 kB)
  • Background: Infectious gastroenteritis is a significant cause of morbidity in childhood and is associated with multiple etiologic organisms. There are several traditional methods of testing stool for bacterial, parasitic, and viral causes of gastroenteritis with different sensitivities and turnaround times. These can limit a timely diagnosis, increase length of stay and lead to unnecessary use of antimicrobials. New multiplex molecular assays have been developed that are faster and have a higher sensitivity and specificity. Unfortunately, these assays can detect multiple organisms simultaneously, making it difficult to differentiate true pathogen versus colonization. In January 2015, our institution switched from traditional testing methods to a multiplex polymerase chain reaction (PCR) detection test (FilmArrayTM Gastrointestinal Panel. BioFireDX, Salt Lake City, Utah). The objective of our study was to determine the number of FilmArrayTM panels that detected multiple organisms.

    Methods: We conducted a retrospective data review to examine the number of FilmArrayTM panels that detected multiple organisms in pediatric patients 18 years and younger from January 2015 to December 2015. Stool samples were received from both inpatient and outpatient facilities. The FilmArrayTM panel can detect 22 organisms, including 13 bacteria, 4 parasites, and 5 viruses.

    Results: There were a total of 353 FilmArrayTM panels reviewed, from which 213 (60.3%) yielded positive results. Among the positives, 152 (71%) detected one organism, 45 panels (21%) detected 2 organisms and 16 panels (7.5%) detected 3 or more organisms. No more than 4 organisms were detected in a single panel. Clostridium difficile (C.diff) was the most common isolated organism. In children 5 and younger, C.diff was isolated with another organism 72% of the time.

    Conclusion: Although the FilmArrayTM Gastrointestinal Panel is a useful single modality for determining the etiology of infectious gastroenteritis, more than one organism is frequently detected. Caution should be used when interpreting these results. Further studies are needed to establish the role of colonization versus true pathogens in the pediatric population, especially in children younger than 5 years.

    Saisho Mangla, DO and Tibisay Villalobos, MD, FAAP, Pediatrics, Children's Hospital at Lehigh Valley Health Network, Allentown, PA


    S. Mangla, None

    T. Villalobos, None

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