Impact of the BioFire® FilmArray Gastrointestinal Panel in Children Hospitalized for Acute Gastroenteritis

Background: Molecular assays can improve the diagnosis of acute gastroenteritis (GE) by increasing detection of pathogens, timeliness of results, and appropriate patient management. This study assessed the impact of the FilmArray Gastrointestinal (GI) Panel on patients hospitalized with GE.

Methods: A pre-/post-intervention study was conducted on patients < 18 years presenting to 5 pediatric EDs with chief complaints of GE. During the pre-intervention period (PRE), clinicians ordered standard of care (SOC) testing at their discretion. In contrast, FilmArray GI Panel was performed and results reported in real time in the post-intervention period (POST). The impact of the FilmArray GI Panel on the clinical management of inpatients was determined.

Results: Of the 1050 subjects enrolled in the study to date (571 PRE and 479 POST), 151 (14.3%; 81 PRE and 70 POST) were hospitalized for management of GE symptoms. 35.1% patients hospitalized (HOSP) had an underlying condition compared to 28.9% of patients discharged (DC) (p = 0.125). In the PRE period, 20 (24.7%) HOSP had SOC testing ordered and 5 (6.2%) were positive for pathogens including, E. coli O157:H7, rotavirus, C. difficile and norovirus. In contrast, 54 (77.1%) HOSP had at least 1 pathogen detected on FilmArray GI Panel in the POST period (17 cases with ≥ 2 pathogen). The most common pathogens detected were norovirus (24), adenovirus (9) and C. difficile (16). SOC testing ordered by clinicians would have missed 29 positive cases in the POST period. The mean turn around time decreased by 25 h (42.5 h vs 17.5 h, p < 0.001) using FilmArray GI Panel during POST period. In the PRE period, antibiotics were initiated in 13 (16.0%) patients upon admission despite SOC testing ordered on 5 (45.5%). Antibiotics were not discontinued in 2 patients despite detection of E. coli O157:H7 and norovirus. Of the 10 (14.3%) treated in the POST period, antibiotics were discontinued in 7 and appropriately initiated in 3 patients in < 24 h of FilmArray GI Panel result. 11 patients had C. difficile and virus detected and none were treated for C. difficile infection.

Conclusion: The FilmArray GI Panel enabled rapid and definitive diagnosis in the majority of patients admitted with GE. This may allow for prompt but appropriate use of antibiotics.