The Utility of Biofire Filmarray in Evaluation of Entero Pathogens Triggers in Patients With Chronic Diarrhea
Chronic diarrhea is a common condition and a key symptom in many disorders. It is a major cause of morbidity and mortality worldwide and one of the most common reasons for referral to a gastroenterology clinic.The prevalence varies depending on population and the definition of diarrhea used. It affects approximately 5% of the population at any given point in time, although the exact prevalence is unknown. Diarrhea is associated with 4 pathophysiological mechanisms: osmotic, secretory, exudative and altered motility. It is more useful to classify patients presenting with symptoms of diarrhea according to ''functional'' or ''organic'' characteristics. It is usually difficult to make a reliable differentiation between organic and functional causes in patients with chronic diarrhea based only on history and physical examination .
The standard evaluation of patients with chronic diarrhea that begins with a detailed history, a careful physical examination and then basic diagnostic tests is critical for optimal treatment and prevention. Initially, thought needs to exclude several other possibilities as (a) fecal incontinence masquerading as diarrhea, (b) iatrogenic diarrhea due to drugs, surgery, or therapeutic radiation, (c) chronic infections, and (d) irritable bowel syndrome with diarrhea (IBS-D).
The detection of a broad array of potentially offending agents has traditionally required a combination of microbiologic approaches, including bacterial culture, antigen detection, microscopy, and polymerase chain reaction (PCR). The new multiplex PCR-based panels have several advantages over conventional methods including (i) reduced sample volume requirements, (ii) broad coverage without the need to select specific tests, (iii) enhanced ability to detect coinfections (iv) increased sensitivity and specificity as high as 97-100% and (v) higher throughput.The food and drug administration (FDA) cleared and recommended the use of FilmArray GI panel (BioFire Diagnostics), which targets 22 analytes (bacteria with bacterial toxin, viruses, and parasites)
Study Overview
Status
Status
Conditions
Conditions
Detailed Description
Investigations:
• Routine laboratory investigation: Complete blood picture and differential WBCs count, liver, kidney function tests, RBG, Na, K, CRP, ESR.
• Microbilogical Investigations:
To ensure that good specimens are provided for examination, it is important to note the following:
- A sterile clean dry container must be used for the collection of fecal samples.
- The specimen should be brought to the lab as soon as possible.
- The specimen container should be clearly labeled with the patient's name, date, and time of passage of the specimen.
A) Conventional methods:
Stool samples will be cultured on Selenite broth then subcultured on blood agar, chocolate agar, MacConkeys agar, Sorbitol MacConkys agar: Xylose Lysine Deoxycholate agar (XLD) ,Sabouraud dextrose agar (SDA), blood agar with 10um/ml ampicillin , Cambylobacter CVA agar plates.
Identification of the bacterial organism:
Pure colonies of isolated microorganisms were identified by:
- Morphology on agar.
- Gram stain film was made from the growth to identify morphology of the organism.
- Biochemical reactions tests.
- Detection of antibiotic sensitivity pattern according to CLSI 2019 by disc diffusion method
- Confirmation of results by automated microbial system VITEK 2Compact.
B) Multiplex PCR: for Identification of different causative organisms by Biofire microarray (BioMerieux,France)
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Shaimaa M Abd Elmouez, doctor
- Phone Number: 0201206053222
- Email: shaimaamahmoud886@gmail.com
Study Contact Backup
- Name: asmaa om ahmed, professor
- Phone Number: 0201033153328
- Email: asomar_12@yahoo.com
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
patients with chronic diarrhea recruited from Al-Rajhi Liver Hospital, Assiut University Hospitals, Assiut, Egypt.
Inclusion criteria:
Patients with diarrhea > 4 weeks
- Exclusion criteria:
Age below 18 years old and diarhhoea < 4 weeks.
Description
Inclusion Criteria:
- Patients with diarrhea > 4 weeks
Exclusion Criteria:
- Age below 18 years old and diarhhoea < 4 weeks.
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Evaluation of utility of multiplex PCR in diagnosis of patients with chronic diarrhea.
Time Frame: one year
|
The performance of the FilmArray test in the diarrhea for each pathogen on the panel.
|
one year
|
|
To identify antibiotic sensitivity pattern of microbes
Time Frame: one year
|
Antibiotic sensitivity patterns for causative microbes.
|
one year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Epidemiology of infectious causes in chronic diarrhoea
Time Frame: one year
|
causes of chronic diarrhoea of enrolled specimens will be evaluated at the end of the study.
|
one year
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Maharshak N, Ringel Y, Katibian D, Lundqvist A, Sartor RB, Carroll IM, Ringel-Kulka T. Fecal and Mucosa-Associated Intestinal Microbiota in Patients with Diarrhea-Predominant Irritable Bowel Syndrome. Dig Dis Sci. 2018 Jul;63(7):1890-1899. doi: 10.1007/s10620-018-5086-4. Epub 2018 May 17.
- Buss SN, Leber A, Chapin K, Fey PD, Bankowski MJ, Jones MK, Rogatcheva M, Kanack KJ, Bourzac KM. Multicenter evaluation of the BioFire FilmArray gastrointestinal panel for etiologic diagnosis of infectious gastroenteritis. J Clin Microbiol. 2015 Mar;53(3):915-25. doi: 10.1128/JCM.02674-14. Epub 2015 Jan 14.
Study record dates
Study Major Dates
Study Start (Anticipated)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- AssiutU The utility of Biofire
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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