The utility of multiplex polymerase chain reaction for diagnosis of infectious diarrhoea in a tropical country

Abstract

PurposeThe etiology of infective diarrheaoften remains undiagnosed. We studied the role of multiplex polymerase chain reaction (PCR) for detection of etiological agents of diarrhoea. MethodsFast track diagnostics (FTD)gastroenteritis panel for bacterial and viral pathogens was used to test stool samples from patients with diarrhoea. ResultsStool samples from 276 patients (138 immunocompetent and 138 immunocompromised) with diarrhoea and 138 healthy controls were tested. Bacterial culture was positive in 5 samples. Following agents were isolated: Shigella sonnei(2), Shigella dysentriae(1), SalmonellaParatyphi B(1) and Vibrio cholerae (1). Multiplex PCR panel did not include Vibrio cholerae in its panel. A total of 65 target pathogens were identified in 60/276 (21.7%) patients by multiplex PCR. 28/65(41.1%) and 37/65 (56.9%) were bacterial and viral agents respectively. Identified bacteria were Shigella(20), Salmonella(3), Campylobacter(4) and Clostridium difficile(1). Viral targets identified were Norovirus GII (28), Adenovirus(4), Astrovirus(3) and Sapovirus(2). All the controls were negative for enteropathogens by conventional methods and multiplex PCR. ConclusionsOur detection rates increased from 1.8% (5/276)by conventional methods to 21.7% (60/276)by multiplex PCR, which included both bacterial as well as viral targets.