Clinical Impact of BioFire for Children Hospitalized with Acute Gastroenteritis

Background: Acute gastroenteritis (AGE) is a major cause of pediatric mortality in which causative agents are regularly identified using traditionally methods. However, multiplex-PCR is a rising technology which offers shorter turn-over times and wider menu of pathogens in comparison to the conventional methods. Results of recent studies suggest clinical impact superiority of multiplex-PCR, such as BioFire, over traditional stool testing methods. However, these studies are not focused solely on hospitalized children, and the clinical impact is mostly theoretical.

Objective: To investigate the clinical impact of BioFire testing in real-life diarrheal episodes of hospitalized pediatric patients.

Methods: We retrospectively observed children who were hospitalized between Oct 2018 and Sep 2020 for whom stool specimen for BioFire were submitted, at clinicians’ discretion. For each episode, data regarding demographics, clinical information and stool tests, was collected. Clinical impact for each case was evaluated by changing the antibiotics prescription, following the result of BioFire.

Results: Out of 140 diarrheal episodes, 25 pathogens were found in 24 cases using conventional methods while BioFire identified75 pathogens in 56 cases (p<0.05). Pathogens that were identified more often using Biofire were Campylobacter, Shigella, Rotavirus, Giardia Lamblia and Cryptosporidium. Clinical Impact of the BioFire was observed in 17 out of 140 (12%) overall diarrheal episodes, and in higher rates in previously healthy children (19%) and solid organ transplanted children (15%).

Conclusion: We found that using BioFire for hospitalized children with diarrheal episodes could increase pathogen identification and impact clinical decisions, especially in healthy and transplant patients.