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Updated: Mar 23, 2026
Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
Impact of Multiplex Polymerase Chain Reaction Testing for Respiratory Pathogens on Healthcare Resource Utilization
Anupama Subramony1, Philip Zachariah2, Ariella Krones3
1Department of Pediatrics, Cohen Children's Medical Center, Hofstra-Northwell School of Medicine, New Hyde Park, NY.
Objective:
To assess whether multiplex polymerase chain reaction (mPCR) vs non-mPCR testing impacts the use of antibiotics, chest radiographs, and isolation precautions.
Study Design:
We retrospectively compared use of antibiotics, chest radiographs, and isolation precautions for patients <18 years old (excluding neonates) hospitalized at a tertiary referral center tested for respiratory pathogens in the emergency department or during the first 2 hospital days, during 2 periods: June 2010-June 2012 (non-mPCR group) vs October 2012-May 2014 (mPCR group).
Results:
Subjects (n = 2430) in the mPCR group were older, had more complex chronic conditions, and were admitted to the pediatric intensive care unit more often compared with the non-mPCR (n = 2349) group. Subjects in the mPCR group had more positive tests (42.4% vs 14.4%, P < .01), received fewer days of antibiotics (4 vs 5 median antibiotic days, P < .01), fewer chest radiographs performed, (59% vs 78%, P < .01), and were placed in isolation longer (20 vs 0 median isolation-hours, P < .01) compared with the non-mPCR group. In multivariable regression, patients tested with mPCR were less likely to receive antibiotics for ≥2 days (OR 0.5, 95% CI 0.5-0.6), chest radiographs at admission (OR 0.4, 95% CI 0.3-0.4), and more likely to be in isolation for ≥2 days (OR 2.4, 95% CI 2.1-2.8) compared with the non-mPCR group.
Conclusions:
Use of mPCR testing for respiratory viruses among hospitalized patients was significantly associated with decreased healthcare resource utilization, including decreased use of antibiotics and chest radiographs, and increased use of isolation precautions.
Insights
Multiplex polymerase chain reaction (mPCR) testing for respiratory viruses in hospitalized children reduced antibiotic and chest radiograph use. However, it increased isolation precaution duration, impacting healthcare resource utilization.
Area of Science:
- Clinical microbiology
- Pediatric infectious diseases
- Health services research
Background:
- Rapid diagnostics are crucial for managing pediatric respiratory infections.
- Multiplex polymerase chain reaction (mPCR) offers comprehensive pathogen detection.
- The impact of mPCR on clinical practice and resource utilization requires evaluation.
Purpose of the Study:
- To determine if multiplex polymerase chain reaction (mPCR) testing influences antibiotic use, chest radiograph frequency, and isolation precautions in hospitalized pediatric patients.
- To compare healthcare resource utilization between mPCR and non-mPCR testing groups.
Main Methods:
- Retrospective cohort study comparing two periods: non-mPCR (June 2010-June 2012) and mPCR (October 2012-May 2014).
- Inclusion criteria: patients <18 years old (excluding neonates) hospitalized at a tertiary referral center, tested for respiratory pathogens in the ED or within the first two hospital days.
- Data collected included antibiotic days, chest radiographs, and isolation precaution duration.
Main Results:
- The mPCR group (n=2430) had more positive tests (42.4% vs 14.4%) and patients with complex conditions compared to the non-mPCR group (n=2349).
- mPCR use was associated with fewer median antibiotic days (4 vs 5), less frequent chest radiographs (59% vs 78%), and longer isolation periods (20 vs 0 median hours).
- Multivariable analysis confirmed mPCR was linked to reduced antibiotic use (OR 0.5) and chest radiographs (OR 0.4), but increased isolation (OR 2.4).
Conclusions:
- Multiplex polymerase chain reaction (mPCR) testing for respiratory viruses in hospitalized children is associated with decreased antibiotic and chest radiograph utilization.
- mPCR implementation led to increased use of isolation precautions.
- The study highlights mPCR's significant impact on healthcare resource utilization in pediatric respiratory infections.
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