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Detection of Helicobacter pylori Infection and Antibiotic Resistance via Stool Quantitative Polymerase Chain Reaction Analysis
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Repeat multiplex PCR gastrointestinal panel testing within 14 days yields minimal additional diagnostic information:

Jeffrey Shu1, Hannah Wang2, Anisha Misra3

  • 1Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, USA.

Infection Control and Hospital Epidemiology
|May 15, 2026
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Summary

Repeat gastrointestinal pathogen panel (GIP) testing within 14 days rarely identifies new infections. This study suggests limiting early repeat GIPs to improve diagnostic stewardship and resource allocation.

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Area of Science:

  • Medical Diagnostics
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Expanded multiplex PCR gastrointestinal panels (GIPs) are standard for diagnosing infectious diarrhea.
  • Limited guidelines exist for repeat GIP testing, leading to inconsistent clinical practices.
  • This study addresses the diagnostic yield of repeat GIP testing within a 14-day timeframe.

Purpose of the Study:

  • To evaluate the diagnostic yield of repeat GIP testing within 14 days of an initial test.
  • To assess the rate of new pathogen detection versus pathogen persistence on repeat GIPs.
  • To inform clinical practice and institutional policies regarding early repeat GIP testing.

Main Methods:

  • Retrospective cohort study of adult patients undergoing GIP testing (2019-2024).
  • Included 16,502 patients, analyzing 507 instances of repeat GIP testing within 14 days.
  • Excluded cases with invalid/missing results or C. difficile; repeat testing excluded confirmatory tests on the same sample.

Main Results:

  • Only 3.1% of patients had repeat GIP testing within 14 days.
  • New pathogens were detected in only 4.6% of index-negative and 2.2% of index-positive repeat tests.
  • Pathogen persistence was observed in 51% of index-positive repeat tests; the number needed to test for a new pathogen was 24.

Conclusions:

  • Repeat GIP testing within 14 days offers limited new diagnostic information.
  • Early repeat GIP testing has low utility and may not be cost-effective.
  • Implementing institutional policies to discourage early repeat GIPs could enhance diagnostic stewardship.