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Development of Multiplex Real-Time RT-qPCR Assays for the Detection of SARS-CoV-2, Influenza A/B, and MERS-CoV
Published on: November 10, 2023
Diagnosis of Respiratory Infections Using Syndromic Panels: A Ct-Based Approach Beyond Qualitative Detection
Maria Antonella Zingaropoli1, Gianluca Bruno Tassone2, Eleonora Coratti2
1Microbiology and Virology Unit, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy.
Microorganisms
|July 28, 2026
Summary
Pediatric patients with acute respiratory infections show higher pathogen detection rates and co-infections. Multiplex syndromic panels reveal specific pathogen dynamics, aiding diagnostic stewardship.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Respiratory Medicine
Background:
- Acute respiratory infections (ARIs) pose a significant global health burden.
- Multiplex syndromic panels are increasingly used for rapid pathogen identification.
- Understanding pathogen prevalence and dynamics is crucial for effective management.
Purpose of the Study:
- To evaluate age-related pathogen prevalence and seasonal dynamics in hospitalized patients with suspected ARIs.
- To analyze Cycle threshold (Ct) values and pathogen co-detections using a multiplex syndromic panel.
- To assess the utility of semi-quantitative interpretation for diagnostic stewardship.
Main Methods:
- Retrospective analysis of 2479 nasopharyngeal swabs from hospitalized patients (Sept 2023 - Oct 2025).
- Utilized a multiplex syndromic panel for pathogen detection.
- Calculated median-based Delta Ct to define pathogen dominance in co-detections.
Main Results:
- 54.4% of samples tested positive for at least one pathogen.
- Pediatric patients had significantly higher positivity rates and co-detections than adults (p < 0.0001).
- Respiratory Syncytial Virus (RSV) and influenza viruses showed low Ct values, while Rhinovirus/Enterovirus (RV/EV), Adenovirus (Adv), and human bocavirus (HBoV) had higher Ct values when co-detected.
Conclusions:
- Pediatric populations exhibit distinct ARI pathogen profiles and higher co-detection rates.
- Semi-quantitative analysis of Ct values provides insights into pathogen interactions and dominance.
- Integrating semi-quantitative data into syndromic panel reporting can improve diagnostic stewardship and resource allocation.
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