A Game Changer for Acute Gastroenteritis in the Pediatric Emergency Department: Multiplex Stool PCR Test.

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis Pub Date : 2025-06-06 DOI:10.1002/jcla.70067

Dogan Barut, Caner Turan, Ezgi Boluk, Sohret Aydemir, Ali Yurtseven, Eylem Ulas Saz

{"title":"A Game Changer for Acute Gastroenteritis in the Pediatric Emergency Department: Multiplex Stool PCR Test.","authors":"Dogan Barut, Caner Turan, Ezgi Boluk, Sohret Aydemir, Ali Yurtseven, Eylem Ulas Saz","doi":"10.1002/jcla.70067","DOIUrl":null,"url":null,"abstract":"Objective: This study evaluated the diagnostic performance of the FilmArray GI Panel multiplex polymerase chain reaction (PCR) compared to conventional stool culture (CSC) and microscopic stool analysis in children with bacterial acute infectious gastroenteritis (AIG) in the emergency department (ED). It also assessed the impact of PCR use on clinical decision-making, antibiotic stewardship, and ED workflow.Methods: A retrospective analysis was conducted in a tertiary pediatric ED. Children diagnosed with AIG who underwent CSC, microscopy, and multiplex PCR were included. Data on demographics, clinical findings, diagnostic results, antibiotic prescriptions, and patient outcomes were collected. Diagnostic performance metrics-sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV)-were compared.Results: Among 257 pediatric patients, enteropathogens were detected in 31.9% via CSC and 39.3% via multiplex PCR. PCR showed superior sensitivity (96.2%) and NPV (97.4%) compared to CSC. The median turnaround time for PCR (7.9 h) was significantly shorter than for CSC (47.5 h, p < 0.001). Antibiotic use was significantly lower in PCR-negative cases (p < 0.001), and ED length of stay was also reduced.Conclusion: The FilmArray GI Panel offers improved sensitivity and faster results than conventional methods, enhancing diagnostic accuracy and reducing unnecessary antibiotic use. Its integration in ED protocols can support antimicrobial stewardship and streamline care.","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":" ","pages":"e70067"},"PeriodicalIF":2.6000,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Laboratory Analysis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jcla.70067","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: This study evaluated the diagnostic performance of the FilmArray GI Panel multiplex polymerase chain reaction (PCR) compared to conventional stool culture (CSC) and microscopic stool analysis in children with bacterial acute infectious gastroenteritis (AIG) in the emergency department (ED). It also assessed the impact of PCR use on clinical decision-making, antibiotic stewardship, and ED workflow.

Methods: A retrospective analysis was conducted in a tertiary pediatric ED. Children diagnosed with AIG who underwent CSC, microscopy, and multiplex PCR were included. Data on demographics, clinical findings, diagnostic results, antibiotic prescriptions, and patient outcomes were collected. Diagnostic performance metrics-sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV)-were compared.

Results: Among 257 pediatric patients, enteropathogens were detected in 31.9% via CSC and 39.3% via multiplex PCR. PCR showed superior sensitivity (96.2%) and NPV (97.4%) compared to CSC. The median turnaround time for PCR (7.9 h) was significantly shorter than for CSC (47.5 h, p < 0.001). Antibiotic use was significantly lower in PCR-negative cases (p < 0.001), and ED length of stay was also reduced.

Conclusion: The FilmArray GI Panel offers improved sensitivity and faster results than conventional methods, enhancing diagnostic accuracy and reducing unnecessary antibiotic use. Its integration in ED protocols can support antimicrobial stewardship and streamline care.

查看原文本刊更多论文

儿科急诊科急性肠胃炎的游戏规则改变者：多重粪便PCR检测。

目的：本研究评价FilmArray GI Panel多重聚合酶链反应（PCR）与常规粪便培养（CSC）和显微镜粪便分析对急诊科（ED）细菌性急性感染性胃肠炎（AIG）患儿的诊断价值。它还评估了PCR使用对临床决策、抗生素管理和ED工作流程的影响。方法：对一所三级儿科急诊科进行回顾性分析。诊断为AIG的儿童接受了CSC、显微镜和多重PCR检查。收集了人口统计学、临床表现、诊断结果、抗生素处方和患者预后方面的数据。比较诊断性能指标敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。结果：257例患儿中，CSC检出肠道病原体的比例为31.9%，多重PCR检出肠道病原体的比例为39.3%。与CSC相比，PCR的敏感性为96.2%，NPV为97.4%。PCR的中位周转时间（7.9 h）明显短于CSC （47.5 h）。结论：与传统方法相比，FilmArray GI Panel提供了更高的灵敏度和更快的结果，提高了诊断准确性并减少了不必要的抗生素使用。将其整合到急诊科方案中可以支持抗菌药物管理并简化护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Clinical Laboratory Analysis 医学-医学实验技术

CiteScore

5.60

自引率

7.40%

发文量

584

审稿时长

6-12 weeks

期刊介绍： Journal of Clinical Laboratory Analysis publishes original articles on newly developing modes of technology and laboratory assays, with emphasis on their application in current and future clinical laboratory testing. This includes reports from the following fields: immunochemistry and toxicology, hematology and hematopathology, immunopathology, molecular diagnostics, microbiology, genetic testing, immunohematology, and clinical chemistry.