Session Type: ePosters
Session Title: ePosters
Authors(s): J. Kosar (1), S. Peermohamed (2), R. Northey (3), S. Leung (3), S. Sanche (2), J. Blondeau (3), C. Hamula (3)
Authors Affiliations(s): (1) Department of Pharmacy, University of Saskatchewan College of Medicine, Canada, (2) Division of Infectious Diseases, Department of Medicine, University of Saskatchewan College of Medicine, Canada, (3) Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, University of Saskatchewan College of Medicine, Canada
Third Party Affiliation: None
Background:
Syndromic gastrointestinal pathogen PCR panels (GIPPs) shorten result turnaround time and improve sensitivity of detection over traditional methods. Studies examining the clinical impact of these panels are contradictory. Implementation of GIPPs often results in decreased antibiotic usage, decreased number of clinical interventions and shortened hospital length of stay for inpatients. However, some studies find GIPPS to be overly sensitive to non-viable organisms resulting in false positive results, increased medical procedures and unnecessary treatment. These findings are dependent on the organism in question and a patient’s underlying condition. We compared patient and treatment outcomes between conventional methodologies (stool culture, ova and parasite exam) and a multiplex GIPP (BD Max bacterial, extended bacterial, parasite and viral panels) at a Canadian tertiary care hospital (Royal University Hospital, Saskatoon, Saskatchewan, Canada).
Methods:Charts were reviewed for 600 inpatients both prior to (n=300) and after (n=300) GIPP implementation in November 2020. Testing outcomes measured include pathogen recovery and identification turnaround times. Patient outcomes examined included length of stay, time to effective antimicrobial therapy, length of effective antimicrobial therapy, appropriateness of antimicrobial treatment, number of imaging studies, and surgical interventions.
Results:Preliminary analysis of 410 bacterial, 430 parasite and 131 total viral specimens run via PCR reveals that overall specimen positivity rate increased by 12% compared to conventional methods following introduction of GIPP. The most frequently isolated species by PCR were Yersinia entercolitica (3.17%), shigatoxigenic E.coli (2.2%), Giardia spp. (1.86%) and Norovirus (5.34%). Pathogen identifications with batched BD Max runs were on average 24h earlier than identifications obtained via stool culture; this difference was closer to 48h for Campylobacter spp. Parasite identifications saw an average turnaround time decrease of 49.2h. Results for bacterial targets with a cycle threshold over 35 were less likely to grow on subsequent culture (p < 0.05).
Conclusions:Introduction of GIPP has improved sensitivity of pathogen detection and result turnaround times in our institution. Careful review of PCR amplification curves is required in order to identify potential false positive results. Further studies are ongoing to compare patient and treatment outcomes.
Keyword(s): syndromic testing, gastrointestinal infections, patient outcomesSession Type: ePosters
Session Title: ePosters
Authors(s): J. Kosar (1), S. Peermohamed (2), R. Northey (3), S. Leung (3), S. Sanche (2), J. Blondeau (3), C. Hamula (3)
Authors Affiliations(s): (1) Department of Pharmacy, University of Saskatchewan College of Medicine, Canada, (2) Division of Infectious Diseases, Department of Medicine, University of Saskatchewan College of Medicine, Canada, (3) Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, University of Saskatchewan College of Medicine, Canada
Third Party Affiliation: None
Background:
Syndromic gastrointestinal pathogen PCR panels (GIPPs) shorten result turnaround time and improve sensitivity of detection over traditional methods. Studies examining the clinical impact of these panels are contradictory. Implementation of GIPPs often results in decreased antibiotic usage, decreased number of clinical interventions and shortened hospital length of stay for inpatients. However, some studies find GIPPS to be overly sensitive to non-viable organisms resulting in false positive results, increased medical procedures and unnecessary treatment. These findings are dependent on the organism in question and a patient’s underlying condition. We compared patient and treatment outcomes between conventional methodologies (stool culture, ova and parasite exam) and a multiplex GIPP (BD Max bacterial, extended bacterial, parasite and viral panels) at a Canadian tertiary care hospital (Royal University Hospital, Saskatoon, Saskatchewan, Canada).
Methods:Charts were reviewed for 600 inpatients both prior to (n=300) and after (n=300) GIPP implementation in November 2020. Testing outcomes measured include pathogen recovery and identification turnaround times. Patient outcomes examined included length of stay, time to effective antimicrobial therapy, length of effective antimicrobial therapy, appropriateness of antimicrobial treatment, number of imaging studies, and surgical interventions.
Results:Preliminary analysis of 410 bacterial, 430 parasite and 131 total viral specimens run via PCR reveals that overall specimen positivity rate increased by 12% compared to conventional methods following introduction of GIPP. The most frequently isolated species by PCR were Yersinia entercolitica (3.17%), shigatoxigenic E.coli (2.2%), Giardia spp. (1.86%) and Norovirus (5.34%). Pathogen identifications with batched BD Max runs were on average 24h earlier than identifications obtained via stool culture; this difference was closer to 48h for Campylobacter spp. Parasite identifications saw an average turnaround time decrease of 49.2h. Results for bacterial targets with a cycle threshold over 35 were less likely to grow on subsequent culture (p < 0.05).
Conclusions:Introduction of GIPP has improved sensitivity of pathogen detection and result turnaround times in our institution. Careful review of PCR amplification curves is required in order to identify potential false positive results. Further studies are ongoing to compare patient and treatment outcomes.
Keyword(s): syndromic testing, gastrointestinal infections, patient outcomes
University of Saskatchewan College of Medicine
Session Type: ePosters
Session Title: ePosters
Authors(s): J. Kosar (1), S. Peermohamed (2), R. Northey (3), S. Leung (3), S. Sanche (2), J. Blondeau (3), C. Hamula (3)
Authors Affiliations(s): (1) Department of Pharmacy, University of Saskatchewan College of Medicine, Canada, (2) Division of Infectious Diseases, Department of Medicine, University of Saskatchewan College of Medicine, Canada, (3) Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, University of Saskatchewan College of Medicine, Canada
Third Party Affiliation: None
Background:
Syndromic gastrointestinal pathogen PCR panels (GIPPs) shorten result turnaround time and improve sensitivity of detection over traditional methods. Studies examining the clinical impact of these panels are contradictory. Implementation of GIPPs often results in decreased antibiotic usage, decreased number of clinical interventions and shortened hospital length of stay for inpatients. However, some studies find GIPPS to be overly sensitive to non-viable organisms resulting in false positive results, increased medical procedures and unnecessary treatment. These findings are dependent on the organism in question and a patient’s underlying condition. We compared patient and treatment outcomes between conventional methodologies (stool culture, ova and parasite exam) and a multiplex GIPP (BD Max bacterial, extended bacterial, parasite and viral panels) at a Canadian tertiary care hospital (Royal University Hospital, Saskatoon, Saskatchewan, Canada).
Methods:Charts were reviewed for 600 inpatients both prior to (n=300) and after (n=300) GIPP implementation in November 2020. Testing outcomes measured include pathogen recovery and identification turnaround times. Patient outcomes examined included length of stay, time to effective antimicrobial therapy, length of effective antimicrobial therapy, appropriateness of antimicrobial treatment, number of imaging studies, and surgical interventions.
Results:Preliminary analysis of 410 bacterial, 430 parasite and 131 total viral specimens run via PCR reveals that overall specimen positivity rate increased by 12% compared to conventional methods following introduction of GIPP. The most frequently isolated species by PCR were Yersinia entercolitica (3.17%), shigatoxigenic E.coli (2.2%), Giardia spp. (1.86%) and Norovirus (5.34%). Pathogen identifications with batched BD Max runs were on average 24h earlier than identifications obtained via stool culture; this difference was closer to 48h for Campylobacter spp. Parasite identifications saw an average turnaround time decrease of 49.2h. Results for bacterial targets with a cycle threshold over 35 were less likely to grow on subsequent culture (p < 0.05).
Conclusions:Introduction of GIPP has improved sensitivity of pathogen detection and result turnaround times in our institution. Careful review of PCR amplification curves is required in order to identify potential false positive results. Further studies are ongoing to compare patient and treatment outcomes.
Keyword(s): syndromic testing, gastrointestinal infections, patient outcomesSession Type: ePosters
Session Title: ePosters
Authors(s): J. Kosar (1), S. Peermohamed (2), R. Northey (3), S. Leung (3), S. Sanche (2), J. Blondeau (3), C. Hamula (3)
Authors Affiliations(s): (1) Department of Pharmacy, University of Saskatchewan College of Medicine, Canada, (2) Division of Infectious Diseases, Department of Medicine, University of Saskatchewan College of Medicine, Canada, (3) Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, University of Saskatchewan College of Medicine, Canada
Third Party Affiliation: None
Background:
Syndromic gastrointestinal pathogen PCR panels (GIPPs) shorten result turnaround time and improve sensitivity of detection over traditional methods. Studies examining the clinical impact of these panels are contradictory. Implementation of GIPPs often results in decreased antibiotic usage, decreased number of clinical interventions and shortened hospital length of stay for inpatients. However, some studies find GIPPS to be overly sensitive to non-viable organisms resulting in false positive results, increased medical procedures and unnecessary treatment. These findings are dependent on the organism in question and a patient’s underlying condition. We compared patient and treatment outcomes between conventional methodologies (stool culture, ova and parasite exam) and a multiplex GIPP (BD Max bacterial, extended bacterial, parasite and viral panels) at a Canadian tertiary care hospital (Royal University Hospital, Saskatoon, Saskatchewan, Canada).
Methods:Charts were reviewed for 600 inpatients both prior to (n=300) and after (n=300) GIPP implementation in November 2020. Testing outcomes measured include pathogen recovery and identification turnaround times. Patient outcomes examined included length of stay, time to effective antimicrobial therapy, length of effective antimicrobial therapy, appropriateness of antimicrobial treatment, number of imaging studies, and surgical interventions.
Results:Preliminary analysis of 410 bacterial, 430 parasite and 131 total viral specimens run via PCR reveals that overall specimen positivity rate increased by 12% compared to conventional methods following introduction of GIPP. The most frequently isolated species by PCR were Yersinia entercolitica (3.17%), shigatoxigenic E.coli (2.2%), Giardia spp. (1.86%) and Norovirus (5.34%). Pathogen identifications with batched BD Max runs were on average 24h earlier than identifications obtained via stool culture; this difference was closer to 48h for Campylobacter spp. Parasite identifications saw an average turnaround time decrease of 49.2h. Results for bacterial targets with a cycle threshold over 35 were less likely to grow on subsequent culture (p < 0.05).
Conclusions:Introduction of GIPP has improved sensitivity of pathogen detection and result turnaround times in our institution. Careful review of PCR amplification curves is required in order to identify potential false positive results. Further studies are ongoing to compare patient and treatment outcomes.
Keyword(s): syndromic testing, gastrointestinal infections, patient outcomes