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Gastrointestinal Panel Performance for the Diagnosis of Acute Gastroenteritis in Pediatric Patients
Marwa Sameer1, Abdulrahman Masood2, Lateefa Almutawea1
1Pediatric and Neonatology Department, King Hamad University Hospital, Muharraq, BHR.
Insights
The gastrointestinal (GI) panel effectively identifies pathogens in children with acute gastroenteritis (AGE). This multiplex PCR test aids in diagnosing infections and guiding clinical management in pediatric patients.
Area of Science:
- Pediatric Infectious Diseases
- Molecular Diagnostics
- Microbiology
Background:
- Acute gastroenteritis (AGE) in children necessitates accurate etiological identification.
- Multiplex real-time PCR gastrointestinal (GI) panels offer rapid detection of numerous pathogens.
- Assessing the clinical utility of GI panels in pediatric AGE management is crucial.
Purpose of the Study:
- To evaluate the impact of the gastrointestinal (GI) panel on the clinical management of acute gastroenteritis (AGE) in pediatric inpatients.
- To determine the diagnostic yield of the GI panel compared to traditional methods like stool culture.
- To analyze pathogen detection patterns and their correlation with disease severity.
Main Methods:
- Retrospective analysis of inpatient data for children with AGE over one year.
- Collection of GI panel results and clinical information.
- Comparison of GI panel findings with stool culture and stool analysis.
Main Results:
- The GI panel detected pathogens in 88.1% of samples, with higher positivity in toddlers.
- Commonly identified pathogens included *Salmonella*, enteropathogenic *Escherichia coli*, and Norovirus.
- The GI panel identified pathogens missed by stool cultures in 56.9% of cases, particularly viruses.
Conclusions:
- The GI panel is a valuable tool for diagnosing the causative agents of pediatric AGE.
- The panel's ability to detect multiple organisms may indicate carrier status, warranting further investigation.
- GI panel results can inform clinical decisions and improve the diagnosis of infectious gastroenteritis in children.
Background:
Various methods are used to identify the causative organisms of acute gastroenteritis (AGE) in children. The gastrointestinal (GI) panel has the potential to detect up to 22 pathogens rapidly through the multiplex real-time PCR test. We studied the impact of the GI panel on clinical management in the pediatric population.
Methods:
A retrospective study was conducted to collect data on GI panel results and clinical details of inpatient children presenting with AGE at King Hamad University Hospital, Kingdom of Bahrain, over the course of one year.
Results:
One hundred nine samples were collected. The GI panel was positive in 96 samples (88.1%), with the majority detected in the toddler age group. Forty-one (42.7%) samples were positive for at least one organism. Salmonella was the most frequently encountered bacteria as a single isolate, 10/55 (18.2%), while enteropathogenic Escherichia coli was the most common co-infected organism, 16/41 (39%). Norovirus was the most common virus among the viruses. Bacterial detection peaked from July to October, while viral detection plateaued throughout the year. The GI panel and stool culture were positive for the same organism in 17 samples, versus one sample with a different organism. Sixty-two (56.9%) samples had a positive GI panel but negative stool cultures and stool analysis, and half of those detected viruses. The GI panel was positive in 86.2% of severely ill patients; the majority were bacteria. Bacterial detection was associated with a higher CRP compared to viruses.
Conclusion:
The GI panel is an informative tool for detecting the causative pathogen of AGE in children. However, it can detect multiple organisms, indicating a possible carrier status, which points toward future studies.
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