Open Access1149. Application of a Multiplex Polymerase Chain Reaction Test for Diagnosing Bacterial Enteritis in Children in a Real-Life Clinical Setting
Author(s) -
Hyun Woo Lee,
Seung Beom Han,
Jung-Woo Rhim
Publication year - 2021
Publication title -
open forum infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.546
H-Index - 35
ISSN - 2328-8957
DOI - 10.1093/ofid/ofab466.1342
Subject(s) - medicine , medical diagnosis , enteritis , multiplex polymerase chain reaction , gold standard (test) , gastroenterology , medical record , diarrhea , campylobacter , polymerase chain reaction , bacteria , pathology , biochemistry , genetics , biology , gene , chemistry
Background Although a bacterial multiplex polymerase chain reaction (mPCR) test should be performed selectively in patients with gastrointestinal symptoms consistent with bacterial enteritis, its usefulness has been evaluated upon stool samples as requested by clinicians, without considering the patients’ gastrointestinal symptoms or clinical diagnoses. This study aimed to determine the subjects to bacterial mPCR testing and to interpret the mPCR test results with considering patients’ clinical symptoms and diagnoses. Methods Medical records of 710 pediatric patients for whom a bacterial mPCR test was performed were retrospectively reviewed. Clinical characteristics and mPCR test results were compared between patients with positive mPCR test results ( n = 199) and those with negative mPCR test results ( n = 511) and between patients in whom inflammatory pathogens ( Campylobacter spp. and Salmonella spp.) were identified ( n = 95) and those in whom toxigenic pathogens ( Clostridium spp.) were identified ( n = 70).Results A positive mPCR test result was significantly associated with an older age ( p < 0.001), diagnosis of acute gastroenteritis ( p = 0.021), presence of hematochezia ( p < 0.001), and absence of cough ( p = 0.004). The diagnosis of acute gastroenteritis ( p = 0.003), presence of fever ( p = 0.027) and diarrhea ( p = 0.043), and a higher C-reactive protein level ( p = 0.025) were significantly associated with the identification of inflammatory pathogens rather than toxigenic pathogens in patients with positive mPCR test results. Conclusion Bacterial mPCR testing should be performed selectively based on patients’ clinical symptoms and diagnoses, and its results should be interpreted with considering identified pathogens. Disclosures All Authors : No reported disclosures