DISCUSSION
hematochezia, diarrheal disease, vomiting, diarrhea
INFECTIOUS DIARRHEA, HEMATOCHEZIA, DIARRHEAL DISEASE
In this study, children whose specimens were tested with the BioFire FilmArray had a much shorter time to test result. However, testing stool specimens provided by children who presented to the ED with diarrhea and hematochezia with the BioFire FilmArray was not associated with reductions in health resource utilization. Also, testing specimens with the BioFire FilmArray was not associated with greater patient satisfaction or improved clinical outcome.Previous observational studies in adults reported that the BioFire FilmArray gastrointestinal panel, compared to conventional stool testing, accurately identified pathogens while reducing turnaround times. This facilitated a reduction in the duration of isolation and ED length of stay, while also reducing inappropriate antibiotic use and diagnostic imaging (Previous studies included patients with general diarrheal disease while we only included patients with hematochezia. These populations have inherent differences: children with hematochezia, compared to those without, are more likely to have a bacterial pathogen identified (33.0% versus 7.9%, difference of 25.1, 95% CI of 16.3 to 33.9%), less likely to have viruses detected (31.3% versus 72.3%, difference of −41.0%, 95% CI of −49.9 to −32.1%), and are more likely receive antibiotics (The greater number of children in the BioFire FilmArray arm who experienced vomiting (52%) compared with those in the standard-of-care arm (14%) may have reduced the potential benefit we hypothesized would be seen. This proposition is based on knowledge children with isolated diarrhea (i.e., diarrhea in the absence of vomiting) are less likely to receive intravenous fluids compared to children with vomiting (It is possible that as guidelines for managing infectious diarrhea evolve, and physician adherence improves (A greater number of bacteria were detected in paired specimens collected from children in the BioFire FilmArray group when tested using the BioFire FilmArray (Although use of the BioFire FilmArray gastrointestinal panel in hospitalized adults, at a cost of US$155 per test, has been shown to be cost-effective through reductions in ancillary diagnostic tests, unnecessary antibiotics, and shorter lengths of stay (