Total N (%) | Specialty N (%) | ||||
---|---|---|---|---|---|
Hospitalist | ED | Others | P | ||
Are you aware of any institutional guidelines regarding the use (ordering) of CSF BioFire® testing? | - | - | - | - | 0.2585 |
Yes | 55 (24.3) | 35 (27.3) | 14 (18.0) | 6 (30.0) | |
No | 171 (75.7) | 93 (72.7) | 64 (82.0) | 14 (70.0) | |
Does your institution provide guidelines for interpreting CSF BioFire® results? | - | - | - | - | 0.582 |
Yes | 53 (23.5) | 27 (21.1) | 20 (25.60 | 6 (30.0) | |
No | 173 (76.5) | 101 (78.9) | 58 (74.4) | 14 (70.0) | |
Are you aware of the performance characteristics (sensitivity/specificity/positive predictive value/negative predictive value) of the CSF BioFire® test? | - | - | - | - | 0.0366 |
Yes | 36 (16.0) | 23 (18.0) | 8 (10.4) | 5 (25.0) | |
No | 132 (58.7) | 67 (52.3) | 56 (72.7) | 9 (45.0) | |
Depends on organism | 57 (25.3) | 38 (29.7) | 13 (16.9) | 6 (30.0) | |
On a scale of 1 to 5, with 5 being VERY confident, how confident are you in interpreting the results of the CSF BioFire® test? | - | - | - | - | 0.9394 |
Very confident | 36 (16.1) | 19 (15.1) | 13 (16.9) | 4 (20.0) | |
Confident | 123 (55.1) | 72 (57.1) | 40 (52.0) | 11 (55.0) | |
Somewhat confident | 54 (24.2) | 30 (23.8) | 19 (24.7) | 5 (25.0) | |
Not confident | 10 (4.5) | 5 (4.0) | 5 (6.5) | 0 | |
Unable to interpret | 0 (0) | 0 | 0 | 0 | |
An otherwise healthy 4 year. old patient presents with fevers and headache. His clinical features are not suspicious of bacterial meningitis/encephalitis; however, an LP is done and the CSF bacterial BioFire® results are positive for a bacterial pathogen. Would you start antimicrobials based on positive CSF bacterial BioFire results alone? | - | - | - | - | 0.4466 |
Yes | 188 (83.1) | 103 (81.5) | 68 (87.2) | 17 (85.0) | |
No | 38 (16.8) | 25 (19.5) | 10 (12.8) | 3 (15.0) | |
If no, would you start antimicrobials based on positive CSF bacterial BioFire® results in addition to CSF cell count suggestive of meningitis? | - | - | - | - | 0.0043 |
Yes | 36 (94.7) | 25 (100.0) | 10 (100.0) | 1 (33.3) | |
No | 2 (5.2) | 0 | 0 | 2 (66.7) | |
In the same patient, would you narrow the antibiotics given the positive bacterial BioFire® test without waiting for culture? | - | - | - | - | 0.291 |
Yes | 87 (45.5) | 42 (40.4) | 36 (51.4) | 9 (52.9) | |
No | 104 (54.4) | 62 (59.6) | 345 (48.6) | 8 (47.1) | |
On a 3-week-old febrile infant whose clinical picture is not consistent with bacterial meningitis, would you stop antimicrobials based on positive viral (ex: enterovirus) BioFire® results alone? | - | - | - | 0.4185 | |
Yes | 82 (36.2) | 51 (39.8) | 24 (30.8) | 7 (35.0) | |
No | 144 (63.7) | 77 (60.2) | 54 (69.2) | 13 (65.0) | |
If no, would you stop antibiotics based on a negative bacterial BioFire® result and normal CSF cell counts without waiting for culture? | - | - | - | 0.9182 | |
Yes | 29 (20.5) | 16 (21.3) | 10 (18.9) | 3 (23.1) | |
No | 112 (79.4) | 59 (78.7) | 43 (81.12) | 10 (76.9) |