Impact of the Introduction of a Gastro-intestinal Panel by Polymerase Chain Reaction (PCR).

Study Overview
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Brief Summary
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Evaluation of the impact of the introduction of multiplex PCR panels on the clinical management of patients with gastroenteritis at the University Hospital of Lausanne, Switzerland.

Detailed Description
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Gastrointestinal multiplex PCR panels have been introduced in clinical practice several years ago, but the impact on the management of patients is yet unknown. The investigators are interested to evaluate if the multiplex PCR panels introduced at the University Hospital of Lausanne in July 2017 modified the usual medical care and in particular the prescription of anti-infectious treatments. The high sensitivity of the multiplex PCR panels should allow a more precise diagnosis of the etiology of the gastrointestinal symptoms of the patients than the traditional methods of stool culture and microscopy. The investigators expect therefore to observe a modification of the proportion of patients receiving anti-infectious treatment, but it is uncertain if it will lead to an increase or a decrease in the use of antibiotics. On one hand antibiotics could be prescribed more often due to a greater and faster detection of enteropathogens. On the other hand antibiotics could be prescribed less often due to more precise diagnosis, showing that viruses and certain bacteria do not require antibiotic treatment.

Official Title
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Impact of the Introduction of a Gastro-intestinal Panel by PCR on the Treatment of Patients With Gastroenteritis

Conditions
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Gastroenteritis

Intervention / Treatment
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* Diagnostic Test: Gastro-intestinal panel by PCR


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: Ambulatory patients who consulted the University Hospital of Lausanne between July 2016 and May 2017, and were investigated by traditional methods (stool microscopy and culture). Ambulatory patients who consulted the University Hospital of Lausanne between July 2017 and May 2018 and had stool investigations by a gastro-intestinal panel. Exclusion criteria: Patients for whom there ia record in the file that they do not accept that their data are used for research purposes.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Traditional methods<br>Patients, who consulted for gastro-intestinal symptoms between July 2016 and May 2017, and were investigated by traditional methods (stool microscopy and/or culture). | |
| Gastro-intestinal panel by PCR<br>Patients, who consulted for gastro-intestinal symptoms between July 2017 and May 2018,and were investigated by a gastro-intestinal panel by PCR | Diagnostic Test: Gastro-intestinal panel by PCR<br>* The study will evaluate the change in medical management with the replacement of traditional stool investigations (microscopy and culture) by the new gastrointestinal multiplex PCR panels<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prescription of antibiotics | Number of patients receiving a prescription of antibiotics depending on the type of investigation | Within 1 week of availability of stool result | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pathogens identified | Number and types of pathogens identified depending on the type of investigation | 1 day | 
| Number of PCR tests requested. | Number of patients for whom one, two or more PCR tests were requested. | 1 month | 
| Additional investigations | Number of patients who underwent additional investigations within 1 week after reception of the results of the initial investigations | 1 week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Gastroenteritis, panel by PCR, antibiotic use