Introduction. Infectious gastroenteritis is a common reason for consulting a physician. Although most cases of gastrointestinal illness are self-limiting, the identification of the etiologic pathogen by stool specimen analysis is important in cases of more severe illness and for epidemiological reasons. Due to the broad range of causative pathogens, the conventional examination of a stool specimen is labour-intensive and usually requires different diagnostic methods. Multiplex PCR tests [e.g. BioFire Gastrointestinal (GI) Panel] allow the rapid detecting of up to 22 pathogens in one test. Hypothesis. Using a multiplex PCR panel to test stool specimens for infectious gastroenteritis pathogens can improve the detection rate, reduce the time-to-result and hands-on time and lower the costs of a microbiology laboratory. Aim. This study was aimed at evaluating the detection rate, the workflow and associated costs of stool specimen management using the BioFire GI Panel versus conventional methods. Methodology. Stool specimens were evaluated prospectively during the routine operation. Pathogen detection rate, hands-on time, time-to-result and material and personnel costs were determined for the BioFire GI Panel and conventional methods—the latter based on physician request and excluding viral testing. Results. Analysing 333 specimens collected between 2019 and 2020, the detection rate of enteropathogens was significantly higher with a positivity rate of 39.9 % using the multiplex PCR panel compared with 15.0 % using the conventional methods. The BioFire GI Panel presented results in a median time of 2.2 h compared with 77.5 h for culture and 22.1 h for antigen testing, noting that no tests were performed at weekends except for toxinogenic Clostridioides difficile. Based on list prices, the BioFire GI Panel was nine times more expensive compared with conventional methods, whereas hands-on-time was significantly lower using the BioFire GI Panel. Conclusion. Multiplex PCR panels are valuable tools for laboratory identification of infectious agents causing diarrhoea. The higher costs of such a multiplex PCR panel might be outweighed by the higher detection rate, ease of handling, rapid results and most likely improved patient management. However, these panels do not provide information on antimicrobial susceptibility testing. Therefore, if this is necessary for targeted therapy or if outbreak monitoring and control is required, specimens must still be cultured.

中文翻译：

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多重 PCR 检测组与传统方法在传染性胃肠炎诊断中的检出率、工作流程和相关成本的比较评估

介绍。传染性胃肠炎是咨询医生的常见原因。尽管大多数胃肠道疾病病例具有自限性，但由于流行病学原因，通过粪便标本分析来鉴定病原体对于病情较严重的病例很重要。由于致病病原体种类繁多，粪便标本的常规检查是劳动密集型的，并且通常需要不同的诊断方法。多重 PCR 测试 [例如 BioFire 胃肠道 (GI) 检测组] 可以在一次测试中快速检测多达 22 种病原体。假设。使用多重 PCR 检测粪便样本中的传染性胃肠炎病原体可以提高检出率、缩短获得结果的时间和操作时间，并降低微生物实验室的成本。目的。本研究旨在评估使用 BioFire GI Panel 与传统方法进行粪便标本管理的检出率、工作流程和相关成本。方法。在常规手术期间对粪便标本进行前瞻性评估。 BioFire GI Panel 和传统方法确定了病原体检出率、实际操作时间、获得结果的时间以及材料和人员成本——后者根据医生的要求，不包括病毒检测。结果。对2019年至2020年间采集的333份标本进行分析，多重PCR检测的肠道病原体检出率显着提高，阳性率为39.9%，而传统方法的检出率为15.0%。 BioFire GI 小组在中位时间 2.2 小时内给出结果，而培养时间为 77.5 小时，抗原测试为 22.1 小时，并指出除了产毒艰难梭菌之外，周末没有进行任何测试。根据标价，BioFire GI Panel 比传统方法贵九倍，而使用 BioFire GI Panel 的实际操作时间明显缩短。结论。多重 PCR 检测板是实验室鉴定引起腹泻的传染源的宝贵工具。这种多重 PCR 检测板的较高成本可能会被较高的检测率、易于操作、快速结果以及很可能改善的患者管理所抵消。然而，这些小组不提供有关抗菌药物敏感性测试的信息。因此，如果有必要进行靶向治疗或需要进行疫情监测和控制，仍必须对标本进行培养。