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Clinical impact of a gastrointestinal PCR panel in children with infectious diarrhoea
  1. Jeanne Truong1,2,
  2. Aurélie Cointe3,4,
  3. Enora Le Roux5,6,
  4. Philippe Bidet3,4,
  5. Morgane Michel6,7,
  6. Julien Boize8,
  7. Patricia Mariani-Kurkdjian3,
  8. Marion Caseris1,
  9. Claire Amaris Hobson2,4,
  10. Marie Desmarest8,
  11. Luigi Titomanlio2,8,9,
  12. Albert Faye1,2,6,
  13. Stéphane Bonacorsi3,4
  1. 1General Paediatrics, Robert Debré University Hospital, AP-HP, Paris, France
  2. 2Université de Paris, UFR de médecine Paris-Nord, Paris, Île-de-France, France
  3. 3Microbiology Laboratory, Robert-Debré University Hospital, AP-HP, Paris, Île-de-France, France
  4. 4IAME UMR 1137, INSERM, Paris, Île-de-France, France
  5. 5Unité d'Epidémiologie Clinique, Robert Debré University Hospital, AP-HP, Paris, France
  6. 6ECEVE UMR-1123, INSERM, Paris, Île-de-France, France
  7. 7URC Eco, Hôtel-Dieu, AP-HP, Paris, France
  8. 8Department of Paediatric Emergency Care, Robert Debré University Hospital, AP-HP, Paris, Île-de-France, France
  9. 9U1141, INSERM, Paris, France
  1. Correspondence to Dr Jeanne Truong, Hôpital Robert Debré, Paris, France; jeanne.truong09{at}gmail.com

Abstract

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.

  • gastroenterology
  • infectious disease medicine
  • microbiology
  • molecular biology
  • paediatrics

Data availability statement

Data are available on reasonable request. The data are anonymised (deidentified participant data). They are available from the Robert-Debré University Hospital (secret.ethique@rdb.aphp.fr).

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Data availability statement

Data are available on reasonable request. The data are anonymised (deidentified participant data). They are available from the Robert-Debré University Hospital (secret.ethique@rdb.aphp.fr).

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Footnotes

  • Contributors JT: conceptualisation, methodology, acquisition of data, formal analysis and interpretation of data, writing original draft of the article and revising it critically for important intellectual content. AC: methodology, acquisition of data. ELR: methodology, formal analysis of data, final approval of the version to be submitted. PB: conceptualisation, acquisition of data. MM: formal analysis of data, final approval of the version to be submitted. JB: acquisition of data. PM-K: acquisition of data. MC: interpretation of data, final approval of the version to be submitted. CAH: revising the article critically for important intellectual content, final approval of the version to be submitted. MD: acquisition of data. LT: acquisition of data. AF: methodology, interpretation of data, revising the article critically for important intellectual content, final approval of the version to be submitted, supervision. SB: guarantor, conceptualisation, methodology, acquisition of data, interpretation of data, drafting the article and revising it critically for important intellectual content, final approval of the version to be submitted, supervision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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