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The Perils of Multiplex Gastrointestinal Pathogen Panels: Pseudo-outbreaks of Salmonellae and Entamoeba histolytica in Immunocompromised Hosts

Published online by Cambridge University Press:  10 May 2018

Elizabeth Robilotti*
Affiliation:
Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York Infection Control, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York Department of Medicine, Weill Cornell Medical College, New York, New York.
Eleanor Powell
Affiliation:
Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
Shauna Usiak
Affiliation:
Infection Control, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
Ying Taur
Affiliation:
Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York Department of Medicine, Weill Cornell Medical College, New York, New York.
N. Esther Babady
Affiliation:
Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
Mini Kamboj
Affiliation:
Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York Infection Control, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York Department of Medicine, Weill Cornell Medical College, New York, New York.
*
Address correspondence to Elizabeth Robilotti, MD, MPH, 1275 York Avenue Box 9, New York, NY 10065 (robilote@mskcc.org).

Abstract

Two distinct clusters of gastroenteritis due to Salmonellae and Entamoeba histolytica (EH) were identified using a multiplex gastrointestinal pathogen panel (GPP) at a tertiary-care cancer center. Despite temporo-spatial overlap, our investigation did not corroborate transmission or true infection. In clinical practice, GPPs may render false-positive results.

Infect Control Hosp Epidemiol 2018;867–870

Type
Concise Communication
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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References

REFERENCES

1. Cox, GJ, Matsui, SM, Lo, RS, et al. Etiology and outcome of diarrhea after marrow transplantation: a prospective study. Gastroenterology 1994;107:13981407.CrossRefGoogle ScholarPubMed
2. Halligan, E, Edgeworth, J, Bisnauthsing, K, et al. Multiplex molecular testing for management of infectious gastroenteritis in a hospital setting: a comparative diagnostic and clinical utility study. Clin Microbiol Infect 2014;20:O460O467.CrossRefGoogle Scholar
3. Khare, R, Espy, MJ, Cebelinski, E, et al. Comparative evaluation of two commercial multiplex panels for detection of gastrointestinal pathogens by use of clinical stool specimens. J Clin Microbiol 2014;52:36673673.CrossRefGoogle ScholarPubMed
4. Laude, A, Valot, S, Desoubeaux, G, et al. Is real-time PCR-based diagnosis similar in performance to routine parasitological examination for the identification of Giardia intestinalis, Cryptosporidium parvum/Cryptosporidium hominis and Entamoeba histolytica from stool samples? Evaluation of a new commercial multiplex PCR assay and literature review. Clin Microbiol Infect 2016;22:e191e198.Google Scholar
5. Navidad, JF, Griswold, DJ, Gradus, MS, Bhattacharyya, S. Evaluation of Luminex xTAG gastrointestinal pathogen analyte-specific reagents for high-throughput, simultaneous detection of bacteria, viruses, and parasites of clinical and public health importance. J Clin Microbiol 2013;51:30183024.Google Scholar
6. Smith, AM, Mthanti, MA, Haumann, C, et al. Nosocomial outbreak of Salmonella enterica serovar Typhimurium primarily affecting a pediatric ward in South Africa in 2012. J Clin Microbiol 2014;52:627631.Google Scholar
7. Tan, SH, Lawler, J, Foster, K, et al. Nosocomial transmission of Salmonella typhimurium in renal transplant recipients. J Hosp Infect 2010;75:241242.Google Scholar
8. Wessels, E, Rusman, LG, van Bussel, MJ, Claas, EC. Added value of multiplex Luminex Gastrointestinal Pathogen Panel (xTAG(R) GPP) testing in the diagnosis of infectious gastroenteritis. Clin Microbiol Infect 2014;20:O182O187.Google Scholar
9. Freeman, K, Mistry, H, Tsertsvadze, A, et al. Multiplex tests to identify gastrointestinal bacteria, viruses and parasites in people with suspected infectious gastroenteritis: a systematic review and economic analysis. Health Technol Assess 2017;21:1188.Google Scholar
10. Hitchcock, MM, Gomez, CA, Banaei, N. Low yield of FilmArray GI panel in hospitalized patients with diarrhea: an opportunity for diagnostic stewardship intervention. J Clin Microbiol 2018;56 pii e0155817; doi: 10.1128/JCM.01558-17.Google Scholar