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Clinical impact of a gastrointestinal PCR panel in children with infectious diarrhoea

Title: Clinical impact of a gastrointestinal PCR panel in children with infectious diarrhoea
Authors: Truong, Jeanne; Cointe, Aurélie; Le Roux, Enora; Bidet, Philippe; Michel, Morgane; Boize, Julien; Mariani-Kurkdjian, Patricia; Caseris, Marion; Hobson, Claire Amaris; Desmarest, Marie; Titomanlio, Luigi; Faye, Albert; Bonacorsi, Stéphane
Source: Archives of Disease in Childhood ; volume 107, issue 6, page 601-605 ; ISSN 0003-9888 1468-2044
Publisher Information: BMJ
Publication Year: 2021
Description: Objectives Multiplex gastrointestinal PCR (GI-PCR) allows fast and simultaneous detection of 22 enteric pathogens (including Campylobacter, Salmonella , Shigella /enteroinvasive Escherichia coli (EIEC) , among other bacteria, parasites and viruses). However, its impact on the management of children with infectious diarrhoea remains unknown. Patients/Design All children eligible for stool culture from May to October 2018 were prospectively included in a monocentric study at Robert-Debré University-Hospital. Intervention A GI-PCR (BioFire FilmArray) was performed on each stool sample. Main measures Data on the children’s healthcare management before and after GI-PCR results were collected. Stool culture results were also reported. Results 172 children were included. The main criteria for performing stool analysis were mucous/bloody diarrhoea and/or traveller’s diarrhoea (n=130). GI-PCR’s were positive for 120 patients (70%). The main pathogens were enteroaggregative E. coli (n=39; 23%), enteropathogenic E. coli (n=34; 20%), Shigella /EIEC (n=27; 16%) and Campylobacter (n=21; 12%). Compared with stool cultures, GI-PCR enabled the detection of 21 vs 19 Campylobacter, 12 vs 10 Salmonella, 27 Shigella/ EIEC vs 13 Shigella , 2 vs 2 Yersinia enterocolitica , 1 vs 1 Plesiomonas shigelloides, respectively. Considering the GI-PCR results and before stool culture results, the medical management was revised for 40 patients (23%): 28 initiations, 2 changes and 1 discontinuation of antibiotics, 1 hospitalisation, 2 specific room isolations related to Clostridioides difficile infections, 4 additional test prescriptions and 2 test cancellations. Conclusion The GI-PCR’s results impacted the medical management of gastroenteritis for almostone-fourth of the children, and especially the prescription of appropriate antibiotic treatment before stool culture results.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1136/archdischild-2021-322465
Availability: https://doi.org/10.1136/archdischild-2021-322465; https://syndication.highwire.org/content/doi/10.1136/archdischild-2021-322465
Accession Number: edsbas.BDF8E924
Database: BASE