Comparative Evaluation of Enteric Bacterial Culture and a Molecular Multiplex Syndromic Panel in Children with Acute Gastroenteritis
| Autor: | Xiao-Li Pang, Otto G. Vanderkooi, Byron M. Berenger, Carey-Ann D. Burnham, Jianling Xie, Jonas Szelewicki, Stephen B. Freedman, Bonita E. Lee, Alberto Nettel-Aguirre, Brendon Parsons, Nathan Zelyas, Phillip I. Tarr, Thomas Kellner, Linda Chui |
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| Rok vydání: | 2019 |
| Předmět: |
Microbiology (medical)
Male medicine.medical_specialty Salmonella Microbiological culture medicine.disease_cause Serogroup Gastroenterology Comparative evaluation Interquartile range Internal medicine medicine Humans Multiplex Child Pathogen business.industry Infant Bacteriology Bacterial Infections Acute gastroenteritis Bacterial Typing Techniques Gastroenteritis Gastrointestinal Microbiome Diarrhea Molecular Diagnostic Techniques Child Preschool Acute Disease Female medicine.symptom business |
| Zdroj: | Journal of clinical microbiology. 57(6) |
| ISSN: | 1098-660X |
| Popis: | Although enteric multianalyte syndromic panels are increasingly employed, direct comparisons with traditional methods and the inclusion of host phenotype correlations are limited. Luminex xTAG gastrointestinal pathogen panel (GPP) and culture results are highly concordant. However, phenotypic and microbiological confirmatory testing raises concerns regarding the accuracy of the GPP, especially for Salmonella spp. A total of 3,089 children with gastroenteritis submitted stool specimens, rectal swab specimens, and clinical data. The primary outcome was bacterial pathogen detection agreement for shared targets between culture and the Luminex xTAG GPP. Secondary analyses included phenotype assessment, additional testing of GPP-negative/culture-positive isolate suspensions with the GPP, and in-house and commercial confirmatory nucleic acid testing of GPP-positive/culture-negative extracts. The overall percent agreement between technologies was >99% for each pathogen. Salmonella spp. were detected in specimens from 64 participants: 12 (19%) by culture only, 9 (14%) by GPP only, and 43 (67%) by both techniques. Positive percent agreement for Salmonella spp. was 78.2% (95% confidence interval [CI], 64.6%, 87.8%). Isolate suspensions from the 12 participants with specimens GPP negative/culture positive for Salmonella tested positive by GPP. Specimens GPP positive/culture negative for Salmonella originated in younger children with less diarrhea and more vomiting. GPP-positive/culture-negative specimen extracts tested positive using additional assays for 0/2 Campylobacter-positive specimens, 0/4 Escherichia coli O157-positive specimens, 0/9 Salmonella-positive specimens, and 2/3 Shigella-positive specimens. For both rectal swab and stool samples, the median cycle threshold (CT) values, determined using quantitative PCR, were higher for GPP-negative/culture-positive samples than for GPP-positive/culture-positive samples (for rectal swabs, 36.9 [interquartile range {IQR}, 33.7, 37.1] versus 30.0 [IQR, 26.2, 33.2], respectively [P = 0.002]; for stool samples, 36.9 [IQR, 33.7, 37.1] versus 29.0 [IQR, 24.8, 30.8], respectively [P = 0.001]). GPP and culture have excellent overall agreement; however, for specific pathogens, GPP is less sensitive than culture and, notably, identifies samples false positive for Salmonella spp. |
| Databáze: | OpenAIRE |
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