Mangla, Saisho, DO

Villalobos, Tibisay, MD

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of PediatricsRate of Detection of Multiple Organisms andClostridium difficile with Stool Multiplex PCRDetection Test in Pediatrics (Poster).Saisho Mangla DOLehigh Valley Health Network, saisho.mangla@lvhn.orgTibisay Villalobos MDLehigh Valley Health Network, tibisay.villalobos@lvhn.orgFollow this and additional works at: https://scholarlyworks.lvhn.org/pediatricsPart of the Pediatrics CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtMangla, S. Villalobos, T. (2017, October 4). Rate of Detection of Multiple Organisms and Clostridium difficile with Stool Multiplex PCRDetection Test in Pediatrics. Poster Presented at: IDweek 2017, San Diego, California.  References:1.  Buss SN, Leber A, Chapin K, et al. Multicenter evaluation of the BioFire FilmArray gastrointestinal panel for etiologic diagnosis of infectious gastroenteritis. J Clin Microbiol. 2015 Mar; 53(3):915-25. 2.  Spina A, Kerr KG, Cormican M, et al. Spectrum of enteropathogens detected by the FilmArray GI Panel in a multicentre study of community-acquired gastroenteritis. Clin Microbiol Infect. 2015 Aug; 21(8):719-28. © 2017 Lehigh Valley Health NetworkRate of Detection of Multiple Organisms and Clostridium difficile with Stool Multiplex CPR Detection Test in PediatricsNew multiplex molecular assays have been developed to determine the etiology of infectious gastroenteritis. Unfortunately, these assays can detect multiple organisms simultaneously along with Clostridium difficile (C.diff), making it difficult to differentiate true pathogen versus colonization. In January 2015, our institution switched from traditional testing methods to a multiplex polymerase chain reaction (PCR) detection test (FilmArrayTM Gastrointestinal Panel. BioFireDX, Salt Lake City, Utah). The objective of our study was to determine the number of FilmArrayTM panels that detected C.diff and/or multiple organisms.•  Although the FilmArrayTM Gastrointestinal Panel is a useful single modality for determining the etiology of infectious gastroenteritis, more than one organism is frequently detected.•  C.diff has become the most common organism isolated among children at our institution. •  Caution should be used when interpreting the isolation of C.diff in younger children and when isolated with other organisms since it is likely to be a colonizer.Distribution of Organisms by Multiplex PCR in 2016Figure 2: A total of 294 organisms were detected collectively in all of the positive FilmArrayTM panels. C. difficile was the most commonly isolated organism. 2720141058373 2854 441616362 3 3020406080100120Number of Times Detected703332282523 22209 96 6 52 1 1 1 101020304050607080Number of Times DetectedOrganismSTUDY OBJECTIVES:•  Determine the distribution of organisms detected by the FilmArrayTM panel. METHODS:•  Retrospective data review of FilmArrayTM panels in pediatric patients 18 years and younger from January 2015 to December 2016. •  Stool samples were received from both inpatient and outpatient setting. EXCLUSION CRITERIA:•  Any patient older than 18 years.Figure 1: A total of 416 organisms were detected collectively in all of the positive FilmArrayTM panels. C. difficile was the most commonly isolated organism.Distribution of Organisms by Multiplex PCR in 2015Age Distribution of All C.diff Isolated in 2016925108752113 3452 25130510152025301 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18Number of FilmArray PanelsAgeFigure 3: The age distribution of patient with C.difficile isolated on FilmArrayTM    panels in 2016. Age Distribution of All C.diff Isolated in 2015Figure 4: The age distribution of patient with C.difficile isolated on FilmArrayTM    panels in 2015. 41895314 42 2421232 2 2024681012141618201 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18Number of FilmArray PanelsAge024681012141 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18Number of FilmArray PanelsAgeC.Diff Isolated Alone C.Diff Isolated with another organism C.Diff isolated with two organisms C.diff isolated with 3 organismsAge Distribution of Panels with C.diff Isolated in 2016Figure 7: The age distribution of patient with C.difficile isolated on FilmArrayTM panels. Organisms Isolated with C.diff in 2016Figure 5: The distribution of organisms that were detected in combination with C.difficile.260270 0141063 340 020246810121416Organisms Isolated with C.diff in 2015Figure 6: The distribution of organisms that were detected in combination with C.difficile.3.  Stockmann C, Rogatcheva M, Harrel B, et al. How well does physician selection of microbiologic tests identify Clostridium difficile and other pathogens in paediatric diarrhoea? Insights using multiplex PCR-based detection. Clin Microbiol Infect. 2015 Feb; 21(2):179.e9-15. 4.  Zhang H, Morrison S, Tang YW. Multiplex polymerase chain reaction tests for detection of pathogens associated with gastroenteritis. Clin Lab Med. 2015 Jun; 35(2):461-86. Lehigh Valley Health Network, Allentown, Pennsylvania Saisho Mangla, DO and Tibisay Villalobos, MD, FAAP61 18114111 1 1 1 10246810121416Sapovirus (I, II, IV and V)Norovirus GI/GIIAstrovirusAdenovirus F 40/41Rotavirus AEnteroaggregative E. coli (EAEC)Enteropathogenic E. coli (EPEC)Shiga-like toxin-producing E. coli (STEC)SalmonellaYersinia enterocoliticaCampylobacter (jejuni, coli and upsaliensisCryptosporidiumCONCLUSIONSRESULTSBACKGROUNDTable 1. Twenty Two Potential Organisms that can be Detected by the FilmArrayTM Gastrointestinal PanelBacteria Diarrheagenic E. coli/Shigella Parasites VirusesCampylobacter (jejuni, coli and upsaliensis) Enteroaggregative E. coli (EAEC) Cryptosporidium Adenovirus F 40/41 Clostridium difficile (toxin A/B) Enteropathogenic E. coli (EPEC) Cyclospora cayetanensis AstrovirusPlesiomonas shigelloides Enterotoxigenic E. coli (ETEC) lt/st Entamoeba histolytica Norovirus GI/GII Salmonella Shiga-like toxin-producing E. coli (STEC) stx1/stx2 Giardia lamblia Rotavirus AYersinia enterocolitica E. coli O157 Sapovirus (I, II, IV and V) Vibrio (parahaemolyticus, vulnificus and cholerae) Shigella/Enteroinvasive E. coli (EIEC)   Vibrio cholerae    

Rate of Detection of Multiple Organisms and Clostridium difficile with Stool Multiplex PCR Detection Test in Pediatrics (Poster).

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Rate of Detection of Multiple Organisms and Clostridium difficile with Stool Multiplex PCR Detection Test in Pediatrics (Poster).

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