Background <p>Acute gastroenteritis (AGE), a leading cause of worldwide morbidity, can be triggered by a wide array of pathogens. Syndromic molecular platforms, such as the BioFire<sup>®</sup> FilmArray<sup>®</sup> Gastrointestinal Panel (GIP), allow rapid and comprehensive detection of enteric pathogens; however, evidence on their utility from Saudi Arabia is lacking. This study therefore aimed to assess the prevalence of enteric pathogens, determine the detection yield of the FilmArray GIP, and explore its potential impact on clinical management.</p> Methods <p>We conducted a retrospective cohort study at Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia, from January 2023 to December 2024. All adult patients (≥ 18 years) with suspected AGE tested using the FilmArray GIP were eligible for inclusion. Clinical and laboratory data, GIP findings, antimicrobial therapy, and clinical outcomes were extracted from electronic medical records.</p> Results <p>A total of 176 adult patients with AGE were included in this analysis. The FilmArray GIP detected bacterial pathogens in 86.4% of patients, while viral and parasitic agents were identified in 20.5% and 10.2% of the cohort, respectively. Co-detections were observed in 46.6% of patients, although their clinical relevance remains uncertain. Stool microscopy failed to detect any parasitic pathogens, whereas the multiplex panel identified parasites in 18 patients (<i>p</i> &lt; 0.001). Detection of <i>Salmonella</i> was more than five times higher with the FilmArray GIP compared with stool culture (18.2% versus 3.4%; <i>p</i> &lt; 0.001). The FilmArray GIP was associated with antimicrobial modifications, with no antibiotics prescribed in 30.1% of patients, whereas targeted antimicrobials were initiated in 27.3%. Notably, 8.5% of cases required transmission-based isolation, with <i>Clostridioides difficile</i> infections were more frequently associated with isolation compared with norovirus cases (42.3% versus 15.4%; <i>p</i> = 0.11).</p> Conclusions <p>The FilmArray GIP demonstrated higher detection yield for enteric pathogens compared with conventional diagnostic techniques. Rapid identification of enteric pathogens was temporally associated with antimicrobial optimization and infection control decisions. Taken together, these findings highlight the potential role of syndromic molecular testing in the management of adult AGE.</p> Clinical trial number <p>Not applicable.</p>

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Impact of the BioFire® FilmArray® Gastrointestinal Panel on clinical management of adult acute gastroenteritis: a retrospective analysis from a Saudi tertiary-care setting

  • Rania A. El-Kady,
  • Ammar AlDabbagh,
  • Rasha Mokhtar Elnagar

摘要

Background

Acute gastroenteritis (AGE), a leading cause of worldwide morbidity, can be triggered by a wide array of pathogens. Syndromic molecular platforms, such as the BioFire® FilmArray® Gastrointestinal Panel (GIP), allow rapid and comprehensive detection of enteric pathogens; however, evidence on their utility from Saudi Arabia is lacking. This study therefore aimed to assess the prevalence of enteric pathogens, determine the detection yield of the FilmArray GIP, and explore its potential impact on clinical management.

Methods

We conducted a retrospective cohort study at Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia, from January 2023 to December 2024. All adult patients (≥ 18 years) with suspected AGE tested using the FilmArray GIP were eligible for inclusion. Clinical and laboratory data, GIP findings, antimicrobial therapy, and clinical outcomes were extracted from electronic medical records.

Results

A total of 176 adult patients with AGE were included in this analysis. The FilmArray GIP detected bacterial pathogens in 86.4% of patients, while viral and parasitic agents were identified in 20.5% and 10.2% of the cohort, respectively. Co-detections were observed in 46.6% of patients, although their clinical relevance remains uncertain. Stool microscopy failed to detect any parasitic pathogens, whereas the multiplex panel identified parasites in 18 patients (p < 0.001). Detection of Salmonella was more than five times higher with the FilmArray GIP compared with stool culture (18.2% versus 3.4%; p < 0.001). The FilmArray GIP was associated with antimicrobial modifications, with no antibiotics prescribed in 30.1% of patients, whereas targeted antimicrobials were initiated in 27.3%. Notably, 8.5% of cases required transmission-based isolation, with Clostridioides difficile infections were more frequently associated with isolation compared with norovirus cases (42.3% versus 15.4%; p = 0.11).

Conclusions

The FilmArray GIP demonstrated higher detection yield for enteric pathogens compared with conventional diagnostic techniques. Rapid identification of enteric pathogens was temporally associated with antimicrobial optimization and infection control decisions. Taken together, these findings highlight the potential role of syndromic molecular testing in the management of adult AGE.

Clinical trial number

Not applicable.