Implications of culture-independent panel-based detection of Cyclospora cayetanensis.

The Nebraska Medical Center (TNMC) was conducting an Institutional Review Board 8 approved research study utilizing the BioFire FilmArray Gastrointestinal Panel (BioFire 9 Diagnostics, Salt Lake City, UT) when an outbreak of cyclosporiasis occurred in Iowa and 10 Nebraska (1). The FilmArray GI Panel is a culture-independent molecular test that 11 simultaneously detects 14 bacterial, 5 viral, and 4 protozoal targets (including Cyclospora 12 cayetanensis) directly from stool specimens, irrespective of physician ordering practices or 13 laboratory ordering policies. For the research study, de-identified residual stool specimens, 14 originally submitted to the laboratory based on a health care provider’s suspicion of 15 gastrointestinal illness, were tested with the FilmArray GI Panel. All specimens were tested 16 fresh (not frozen) and within 4 days of the collection date. 17