Detection of Acute Gastroenteritis Agents By Molecular Methods

Yıl 2018, Cilt: 9 Sayı: 1, 21 - 25, 10.03.2018

Şafak Göktaş Ayşegül Aksoy Gökmen Pınar Şamlıoğlu

https://doi.org/10.5799/jcei.413060

Öz

Objective:
Gastroenteritis
is the most important cause of morbidity and mortality in all age groups all
over the world. Multiplex PCR tests give sensitive and specific results in the
investigation of bacterial, viral, parasitic agents. In this study, it was
aimed to determine the agents of the stool specimens of patients with acute
diarrhea by multiplex PCR.

Materials
and Methods: Stool
sample taken from 471 patients sent to Istanbul Gelişim Laboratories between
January 1, 2015 and September 30, 2016 was included in the study. All stool
samples were processed according to manufacturer’s instructions with
GastroFinder SMART 18 FAST multiplex PCR test (Pathofinder, Holland). 18
different gastrointestinal pathogens were diagnosed in one study.

Results:
Of the 471
patients stool sample included in the study. The agent was negative in 241
(51.2%), while the agent was isolated in 230 (48.8%). 190 (82%) had a single
pathogen, 40 had two or more pathogens. Of the 190 samples detected with single
agent, 149 (31.6%) were bacterial, 26 (5.5%) were parasitic and 15 (3.1%) were
viral agents.

Of the 149
bacterial agents, 108 (23%) was detected as Salmonella spp, 14 (6%) as
EHEC, 8 (3.5%) as Clostridium difficile toxin A / B, 8 (3.5%) as Campylobacter
spp., 7 (3%) Aeromonas spp., 2 (0.8%) Yersinia enterocolitica,
2 (0.8%) Enterotoxigenic E. coli (ETEC). Of 26 parasitic agents,
18 (7.8%) was detected as Giardia lamblia, 6 (2.6%) as Dientamoeba
fragilis and 2 (0.8%) as Cryptosporidium spp.

Conclusion:
Identification
of enteric pathogens by multiplex PCR will avoids the use of unnecessary
antibiotic treatments

Anahtar Kelimeler

Gastroenteritis, Multiplex PCR, stool

Kaynakça

• 1.Binnicker MJ. Multiplex moleculer panels for diagnosis of gastrointestinal infection; Performans, result interpretation and cost effectiveness. J Clin Microbiol. 2015;53:3723-7.
• 2. Güneş H, Gökalp AA, Gülen Dumrul, Kaya AD. ADÜ Tıp Fakültesi Dergisi 2012;13:21-4.
• 3. Eibach D, Krumkamp R, Hahn A, et al. Application of a multiplex PZR assay for the detection of gastrointestinal pathogens in a rural African setting. BMC Infect Dis. 2016;16:150.
• 4. Martina A, Ayala AP, Chaves F, Lora D, Orellana A. Evaluation of the multiplex PCR Allplex-GI assay in the detection of bacterial pathogens in diarrheic stool samples. J Microbiol Methods. 2018;144:33–6.
• 5. Khare R, Espy MJ, Cebelinski E, et al. Comparative evaluation of two commercial multiplex panels for detection of gastrointestinal pathogens by use of clinical stool specimens. J Clin Microbiol. 2014;52:3667–73.
• 6. Huang RS, Johnson CL, Pritchard L, Hepler R, Ton TT, Dunn JJ. Performance of the Verigene® enteric pathogens test, Biofire FilmArray™ gastrointestinal panel and Luminex xTAG® gastrointestinal pathogen panel for detection of common enteric pathogens. Diagn Microbiol Infect Dis. 2016;86:336–9.
• 7. Piralla A, Lunghi G, Ardissino G et all. FilmArray™ GI panel performance for the diagnosis of acute gastroenteritis or hemorrhagic diarrhea. BMC Microbiol. 2017;17:111.
• 8. Park S, Hitchcock MM, Gomez CA, Banaei N. Is follow-up testing with FilmArray gastrointestinal multiplex PCR panel necessary? J Clin Microbiol. 2017;55: 1154-61.
• 9. McAuliffe GN, Anderson TP, Stevens M, et al. Systematic application of multiplex PCR enhances the detection of bacteria, parasites, and viruses in stool samples. J Infect. 2013;67:122–9.
• 10. de Boer RF, Ott A, Kesztyüs B, Kooistra-Smid AMD. Improved detection of five major gastrointestinal pathogens by use of a molecular screening approach. J Clin Microbiol. 2010;48:4140–6.
• 11. Khare R, Espy MJ, Cebelinski E, Boxrud D, Sloan LM, Cunningham SA, Pritt BS, Patel R, Binnicker MJ. Comparative evaluation of two commercial multiplex panels for detection of gastrointestinal pathogens by use of clinical stool specimens. J Clin Microbiol. 2014;52:3667–73.
• 12. Gray J, Coupland Lj. The increasing application of multiplex nucleic acid detection tests to the diagnosis of syndromic infections. Epidemiol Infect. 2014;142:1-11.
• 13. Khare R, Espy MJ, Cebelinski E, et al. Comparative evaluation of two commercial multiplex panels for detection of gastrointestinal pathogens by use of clinical stool specimens. J. Clin. Microbiol. 2014;52:3667–73.
• 14. Voca, C, Rimoldi SG, Pagani C, et al. Comparative evaluation of the new xTAG GPP multiplex assay in the laboratory diagnosis of acute gastroenteritis. Clinical assessment and potential application from a multicentre Italian study. Int J Infect Dis. 2015;34: 33–7.
• 15. Buss SN, Leber A, Chapin K, et al. Multicenter evaluation of the BioFire FilmArray gastrointestinal panel for etiologic diagnosis of infectious gastroenteritis. J Clin Microbiol 2015;53:915–25.
• 16. Güneş H, Gökalp AA, Gülen D, Kaya AD. Gastroenteritli Olgularda Salmonella - Shigella Cinsi Bakterilerin İzolasyon Sıklığı ve Antibiyotik Direnç Paternlerinin Değerlendirilmesi. ADÜ Tıp Fakültesi Derg. 2012;13: 21 – 4.
• 17. Onori M, Coltella L, Mancinelli L, et al. Evaluation of a multiplex PZR assay for simultaneous detection of bacterial and viral enteropathogens in stool samples of paediatric patients. Diagnc Microbiol Infect Dis 2014;79:149-54.
• 18. Kayman T, Abay S, Hızlısoy H. Campylobacter Türlerinin Fenotipik Yöntemler ve Multipleks Polimeraz Zincir Reaksiyonu ile Tanımlanması ve Antibiyotik Duyarlılıkları. Mikrobiyol Bul. 2013;47:230-9.
• 19. Gülen A, Hacımustafaoğlu M. Çocuklarda akut infeksiyöz gastroenteritlere genel yaklaşım. ANKEM Derg. 2013;27:147-57.