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Physician-directed microbiological testing versus syndromic multiplex PCR in gastroenteritis.
Bo Massa1, Frederik Van Hoecke2,3, Steven Vervaeke2
1Department of Laboratory Medicine, AZ Delta, Roeselare, Belgium. bomassa97@gmail.com.
Summary
Syndromic multiplex PCR assays significantly improve pathogen detection in gastroenteritis cases compared to conventional testing. This rapid molecular testing offers a superior diagnostic strategy for identifying causative agents in stool samples.
Area of Science:
- Clinical Microbiology
- Molecular Diagnostics
- Infectious Diseases
Background:
- Conventional stool testing relies on physician-directed requests, potentially limiting diagnostic scope.
- Syndromic multiplex PCR offers a comprehensive, rapid alternative for identifying multiple pathogens simultaneously.
Purpose of the Study:
- To compare the etiologic yield of conventional microbiological testing with rapid syndromic multiplex PCR for gastroenteritis.
- To evaluate the adequacy of clinician ordering in diagnostic stewardship for gastroenteritis.
Main Methods:
- A parallel study design was employed, comparing conventional microbiological testing with syndromic multiplex PCR (Fast Track Diagnostics Gastroenteritis Kit).
- 1238 stool samples were analyzed to assess the contribution of multiplex panels to gastroenteritis diagnostics.
Main Results:
- Syndromic testing identified pathogens in 41.3% of samples, compared to 18.4% with conventional methods.
- Physician request forms were deemed adequate in only 15.1% of cases, with 88.2% labeled inadequate.
- Conventional testing missed diagnoses in 32.3% of specimens, and viral/parasitic testing was often not requested despite positive results.
Conclusions:
- Syndromic multiplex PCR assays demonstrate a superior strategy for pathogen detection in gastroenteritis.
- This molecular approach enhances diagnostic yield and addresses limitations of physician-directed conventional testing.
