Abstract
BackgroundPersistent and chronic diarrhea is difficult to treat, and infection is still the main cause. In this study, we investigate the application value of xTAG gastrointestinal pathogen panel (xTAG GPP) multiplex PCR in the early diagnosis of persistent and chronic diarrhea in children and to understand the epidemiology of intestinal diarrhea pathogens.MethodsOne hundred ninety-nine specimens were collected from Nanjing Children’s Hospital Affiliated to Nanjing Medical University (Nanjing, China). We compared the xTAG GPP multiplex PCR assay with traditional methods (culture, rapid enzyme immunoassay chromatography, and microscopic examination) and performed a statistical analysis.ResultsThe positive rate of the xTAG GPP multiplex PCR assay of diarrhea specimens from 199 patients was 72.86% (145/199). The virus detection rate was 48.7%, and rotavirus A was the most common organism detected (34.67%), concentrated in winter, and was common in children. The second most common organism detected was norovirus GI/GII (20.6%). The positive rate of this bacteria was 40.2%, and Campylobacter (22.11%, 44/199) was most frequently detected. C. difficile toxins A/B and Salmonella was detected in 44 and 17 samples, respectively. Infections with Shigella occurred 4 times, and E. coli O157 was only detected once. Three samples were parasitic (1.51%), two samples were positive for Entamoeba histolytica, and one was positive for Cryptosporidium. Adenovirus 40/41, STEC, ETEC, Giardia, Yersinia enterocolitica and Vibrio cholerae were not detected. In total, 86 (43.2%) infected specimens with a single pathogen were detected. There were 59 coinfections (29.65% of the samples) of viruses and/or bacteria and/or parasites. Coinfections involved 49 double infections (24.62%), 9 triple infections (4.52%) and 1 quadruple infections (0.5%). Norovirus GI/GII was found to have the highest involvement, with 32 coinfections (16.08%).ConclusionThe xTAG GPP multiplex PCR assay is simple, sensitive, and specific and can be used as a quick way to diagnose persistent and chronic diarrhea in children.
Highlights
Persistent and chronic diarrhea is difficult to treat, and infection is still the main cause
The development of faster and more sensitive molecular tests that can detect various pathogenic agents of bacteria, viruses and parasites might improve the etiological diagnosis of diarrhea pathogens [9,10,11]
Pathogens detected with the xTAG xTAG gastrointestinal pathogen panel (GPP) In this study, we found that 145 (72.86%) of the collected 199 samples had positive results
Summary
Persistent and chronic diarrhea is difficult to treat, and infection is still the main cause. In developing and industrialized countries, the most common and most important cause of persistent and chronic diarrhea is still enteric infection [5, 6]. It is crucial for timely and effective treatment of infectious diarrhea in the rapid identification of pathogens because appropriate antimicrobial therapy and/or isolation measures to prevent the spread of infectious agents to healthy people can shorten the disease and reduce some bacteria and parasite infection incidence and can help reduce invasive infections [7, 8]. The development of faster and more sensitive molecular tests that can detect various pathogenic agents of bacteria, viruses and parasites might improve the etiological diagnosis of diarrhea pathogens [9,10,11]
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