The high sensitivity of stool culture testing makes it the standard against which other testing methods are often compared. However, despite its sensitivity, stool culture has several shortcomings, especially when stacked against the BioFire® FilmArray® Gastrointestinal (GI) Panel.
Stool culture diagnostics for infectious gastroenteritis come with drawbacks for laboratories, clinicians, and patients alike.
For the lab, stool culture is time consuming and labor intensive. It’s a high-complexity test that usually must be performed by highly skilled laboratorians, and results can take 48 – 96 hours. The required hands-on time can make stool culture costly and inefficient for the lab. Furthermore, separate tests must be ordered for some bacteria and parasites, adding to the labor and resource costs. And after all that time and effort, stool culture offers a yield of only 1.5%-2.9% (according to some reports for some enteric pathogens).1
These challenges also impact clinicians. The low yield of stool culture can lead to serial testing, stacking even more time onto an already-lengthy process. Racing the clock, physicians may end up making empiric treatment decisions without actionable laboratory results.
The low yield and lengthy time to results of stool culture can impact patients as well. With traditional stool culture, patients may end up receiving unnecessary antibiotics or undergoing additional GI testing. And in the end, patients may still not know what has made them sick.
Multiplex PCR testing from BioFire helps overcome the challenges with stool culture. The BioFire GI Panel identifies 22 common gastrointestinal pathogens, including bacteria, viruses, and parasites—all in one test, from one patient sample, with results in about an hour. This syndromic testing approach can provide benefits for laboratories, clinicians, and patients.
In the lab, the BioFire GI Panel can help save technician time and streamline workflow. The BioFire GI Panel is easy to perform and requires only two minutes of hands-on time, returning results in about an hour. This multiplex PCR test has shown a higher detection rate of at least one pathogen when compared with traditional methods (48.2% vs 16.7%), according to a systematic review and metanalysis considering 14 studies.2 With faster and more comprehensive GI pathogen panel results, the BioFire GI Panel may result in fewer additional test orders. In fact, compared with traditional stool culture testing methods, one study demonstrated the BioFire GI Panel has been shown to decrease the average number of additional stool tests from three to about one.3
For clinicians, multiplex PCR testing with the BioFire GI Panel offers fast answers for informed therapy decisions. Compared with traditional stool culture methods, the BioFire GI Panel has been shown to reduce the average time to result by 84%.3 Furthermore, syndromic testing with the BioFire GI Panel demonstrated more targeted therapy in one study (compared with stool culture) and less antibiotics prescribed in another study (compared with conventional stool tests).4,5
Patients also see the benefits of fast, comprehensive results from the BioFire GI Panel. They may receive appropriate treatment sooner, and when results are known at the time of discharge, they may have a reduced length of stay.3 Additionally, they may undergo fewer diagnostic tests like endoscopies and abdominal imaging.5 The BioFire GI Panel may also give them the peace of mind of knowing what is causing their illness.
| BioFire GI Panel | Traditional Testing | |
|---|---|---|
| Time to results | ~1 hour | 48 – 96 hours |
| Yield2 | 48.2% | 16.7% |
| Ave. No. of additional stool tests3 | ~1 | 3 |
| Pathogens detected at a time | 22 | 1 |
Syndromic testing with a gastrointestinal PCR panel can provide economic benefits for laboratories and healthcare organizations. The BioFire GI Panel is intended to be used with the BioFire® FilmArray® Torch in moderate complexity settings. This GI pathogen panel does not require a high level of skill to perform and only involves 2 minutes of laboratorian hands-on time. Additionally, the previously mentioned reduction in the average number of lab tests from 3 to about 1 may bring cost savings to the lab.3
Healthcare organizations may see cost savings from reduced GI testing—the BioFire GI Panel demonstrated a reduction in downstream procedures like endoscopies, CT scans, X-rays, and ultrasounds.3,5 Overall, the BioFire GI Panel led to an estimated $293.61 in cost savings per patient, mainly due to a reduction in average length of stay.3
With similar and overlapping symptoms, the possible causes of gastroenteritis are impossible to distinguish based on clinical presentation alone. Traditional stool culture testing is slow and labor intensive, often leaving clinicians to make treatment decisions without actionable lab results.
BioFire’s syndromic approach uses gastrointestinal multiplex PCR to quickly and accurately identify possible causes of infectious gastroenteritis. Each in vitro diagnostic BioFire® FilmArray® Panel offers a comprehensive target menu, enabling it to identify a broad grouping of probable pathogens in a single, rapid test. It’s more sensitive than stool culture and more efficient than individual and send-out tests.
References:
Diagnostic Stewardship 101