720 - Clinical Performance of Film Array Gastrointestinal Pathogen Panel in Diarrhea

Background: Infective diarrhea is a common problem. Multiplex Polymerase chain reaction (PCR) based pathogen diagnostics of diarrheal stool specimens are shown to be highly sensitive and rapid as opposed to conventional diagnostics.

Methods: We analyzed the performance of a multiplex PCR test, FilmArray (FA) gastrointestinal (GI) panel, on stool specimens in patients admitted with acute and chronic diarrhea to our hospital from December 2016 to December 2019 and compared the results with conventional diagnostic tests.

Results: A total of 98 patients were analyzed, 52 were males and 9 belonged to pediatric age. 92.9% patients presented with acute diarrhea. None were HIV positive. Among 98 tested, FA GI pathogen panel was positive for at least one pathogen in 39.8% patients.  The yield was low for stool culture, 7.79%. In samples tested by FA GI pathogen panel, a single pathogen was identified in 27 patients (27.5%) while multiple targets were identified in 12 patients (12.2%). Majority (76.5%) had normal stool routine. Stool routine abnormality and positive GI pathogen panel did not correlate, as only 7 patients with abnormal stool routine had a positive result in FA GI pathogen panel, while 12 patients had negative result. Among the 39 patients with positive FA GI pathogen panel, only 6 had positive stool culture result. All stool culture positive sample also had GI pathogen panel positive result.   Commonest organism in stool culture was Salmonella (5) while one patient had E. coli. Commonest organism in stool FA GI pathogen panel was also Salmonella, 12 isolates as a single pathogen and 5 as one among the multiple targets identified, making a total of 17 isolates. This is followed by Enteroaggregative E. coli (EAEC- 9) and Enteropathogenic E. coli (EPEC- 5). %). Only one had virus as pathogen (norovirus), no parasitic infection was identified. Multiple pathogens were identified in 12 patients. Clostridium difficile toxin was positive in 2 in whom multiple targets were identified. Among the chronic diarrhea syndrome, none had stool culture positivity while two had positive FA GI pathogen panel results and the organisms were Campylobacter and EAEC.FA GI pathogen panel results
Multiple targets that are identified


Conclusion:
FA GI panel detects a wide array of GI pathogens, better yield and has a quick turn-around-time compared to conventional tests like stool culture.