OBJECTIVES: To determine whether systematic testing of faecal samples with a broad range multiplex PCR increases the diagnostic yield in patients with diarrhoea compared with conventional methods and a clinician initiated testing strategy. METHODS: 1758 faecal samples from 1516 patients with diarrhoea submitted to two diagnostic laboratories were tested for viral, bacterial, and parasitic pathogens by Fast-Track Diagnostics multiplex real-time PCR kits and conventional diagnostic tests. RESULTS: Multiplex PCR detected pathogens in 530 samples (30%): adenovirus (51, 3%), astrovirus (95, 5%), norovirus (172, 10%), rotavirus (3, 0.2%), Campylobacter jejuni/coli (85, 5%), Salmonella spp. (22, 1%), Clostridium difficile (72, 4%), entero-haemorrhagic Escherichia coli (21, 1%), Cryptosporidium spp. (3, 0.2%), Entamoeba histolytica (1, 0.1%), and Giardia lamblia (59, 3%). In contrast, conventional testing detected a pathogen in 324 (18%) samples. CONCLUSIONS: Using a systematic approach to the diagnosis of gastroenteritis improved diagnostic yield. This enhanced detection with PCR was achieved by a combination of improved detection of individual pathogens and detection of pathogens not requested or unable to be tested by conventional tests. This approach also allowed earlier identification for most pathogens and created a workflow which is likely to adapt well for many diagnostic laboratories.
OBJECTIVES: To determine whether systematic testing of faecal samples with a broad range multiplex PCR increases the diagnostic yield in patients with diarrhoea compared with conventional methods and a clinician initiated testing strategy. METHODS: 1758 faecal samples from 1516 patients with diarrhoea submitted to two diagnostic laboratories were tested for viral, bacterial, and parasitic pathogens by Fast-Track Diagnostics multiplex real-time PCR kits and conventional diagnostic tests. RESULTS: Multiplex PCR detected pathogens in 530 samples (30%): adenovirus (51, 3%), astrovirus (95, 5%), norovirus (172, 10%), rotavirus (3, 0.2%), Campylobacter jejuni/coli (85, 5%), Salmonella spp. (22, 1%), Clostridium difficile (72, 4%), entero-haemorrhagic Escherichia coli (21, 1%), Cryptosporidium spp. (3, 0.2%), Entamoeba histolytica (1, 0.1%), and Giardia lamblia (59, 3%). In contrast, conventional testing detected a pathogen in 324 (18%) samples. CONCLUSIONS: Using a systematic approach to the diagnosis of gastroenteritis improved diagnostic yield. This enhanced detection with PCR was achieved by a combination of improved detection of individual pathogens and detection of pathogens not requested or unable to be tested by conventional tests. This approach also allowed earlier identification for most pathogens and created a workflow which is likely to adapt well for many diagnostic laboratories.
Authors: Doudou Sow; Philippe Parola; Khadime Sylla; Magatte Ndiaye; Pascal Delaunay; Philippe Halfon; Sabine Camiade; Thérèse Dieng; Roger C K Tine; Babacar Faye; Jean Louis Ndiaye; Yémou Dieng; Oumar Gaye; Didier Raoult; Fadi Bittar Journal: Am J Trop Med Hyg Date: 2017-07 Impact factor: 2.345
Authors: S M Harrington; B W Buchan; C Doern; R Fader; M J Ferraro; D R Pillai; J Rychert; L Doyle; A Lainesse; T Karchmer; J E Mortensen Journal: J Clin Microbiol Date: 2015-03-04 Impact factor: 5.948
Authors: Marijo Parčina; Ingrid Reiter-Owona; Frank P Mockenhaupt; Valerija Vojvoda; Jean Bosco Gahutu; Achim Hoerauf; Ralf Ignatius Journal: Parasitol Res Date: 2017-12-19 Impact factor: 2.289
Authors: Mark S Riddle; Gregory J Martin; Clinton K Murray; Timothy H Burgess; Patrick Connor; James D Mancuso; Elizabeth R Schnaubelt; Timothy P Ballard; Jamie Fraser; David R Tribble Journal: Mil Med Date: 2017-09 Impact factor: 1.437