Improving syndromic testing in oncology: performance characteristics of multiplex PCR assays for evaluation of infectious gastroenteritis among hospitalized cancer patients.

Authors

Justin Laracy, Judy Yan, Rich Kodama, Shauna Usiak, Emily Walits, Tania Bubb, Mini Kamboj

Published in

Antimicrobial stewardship & healthcare epidemiology : ASHE. Volume 6. Issue 1. Pages e202. Epub Jul 07, 2026.

Abstract

Multiplex gastrointestinal polymerase chain reaction (GI-PCR) tests of the stool for the evaluation of infectious diarrhea are prone to false-positive target detections. However, there is no recommended testing approach in immunocompromised cancer patients who are often excluded from diagnostic stewardship protocols. The aim of this study was to evaluate the performance characteristics of the BioFire® FilmArray® GI-PCR and assess whether the findings support a diagnostic stewardship approach to limit testing among hospitalized cancer patients.
A retrospective study of 29,727 GI-PCR tests was performed at Memorial Sloan Kettering Cancer Center in New York City, evaluating data from February 1, 2020, to January 29, 2025. All tests sent from all locations and across all patient types were included in the study.
The overall GI-PCR positivity rate was greatest in the outpatient setting at 23.4% and dropped at 15.6% in the early stage of admission (hospital days 0-2) and 10.1% in the late stage of admission (hospital day 3 and beyond). Across all subgroups analyzed, norovirus and Enteropathogenic E. coli (EPEC) were the most frequently detected targets with all remaining targets detected at rates below 2%. The low pathogen detection rate was preserved among patients with neutropenia and recipients of recent cellular therapy.
BioFire FilmArray GI panel has low utility in the inpatient setting including for severely immunosuppressed hosts. These observations identify a potential opportunity for diagnostic stewardship and suggest that commonly applied testing restrictions may warrant further evaluation in immunocompromised oncology populations.

PMID:
42422866
Bibliographic data and abstract were imported from PubMed on 09 Jul 2026.

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