Utility of a Multiplex Molecular Respiratory Pathogen Panel on Clinical Management of Children in the Pediatric...

Area of Science:

• Pediatric Emergency Medicine
• Infectious Disease Diagnostics
• Molecular Diagnostics

Background:

• Acute respiratory infections (ARI) are a leading cause of pediatric emergency department (PED) visits.
• Rapid molecular respiratory pathogen panels (RPPs) are increasingly used in diagnosing pediatric ARI.
• The clinical utility and impact of RPPs on management in the PED require further investigation.

Purpose of the Study:

• To evaluate the impact of RPPs on the clinical management of children in the PED.
• To assess the effect of implementing restrictive criteria for RPP orders.
• To determine if RPP results influence disease severity assessment or treatment decisions.

Main Methods:

• Retrospective analysis of PED RPP orders from June 2023 to June 2024.
• Inclusion of 400 patients (infants <1 year, children 1-5 years) with even RPP positive/negative distribution.
• Chart abstraction for clinical presentation, management, and disease severity (Emergency Severity Index).

Main Results:

• Of 2,052 RPPs performed, 71.3% were positive for at least one target.
• No significant differences in disease severity (ESI 3.7) or clinical management were observed between RPP positive and negative patients.
• Retrospective application of stewardship criteria suggested a potential 48% reduction in RPP testing.

Conclusions:

• RPP results, whether positive or negative, had a limited impact on clinical management decisions in the PED.
• Stewardship interventions show potential for reducing unnecessary RPP testing and associated costs.
• Optimizing RPP utilization is crucial for cost-effectiveness while ensuring identification of critical pathogens.