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2020, Number 3

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Rev Mex Patol Clin Med Lab 2020; 67 (3)

Impact of a multiplex PCR on the diagnosis and treatment of patients with acute infectious gastroenteritis

Hernández RJ, Morales AC, Núñez MM

Language: Spanish
References: 24
Page: 129-141
PDF size: 310.17 Kb.


ABSTRACT

Acute infectious gastroenteritis continues to be a public health problem, causing more than five million cases of diarrhea of infectious origin, with a high economic cost and human lives. Diagnosis traditionally employs microbiological and immunological methods with results from hours to days; multiplex PCR tests allow to analyze more than 20 pathogens in less time. Objective: Identification of the causative agent, diagnosis and specific treatment, inappropriate use of antibiotics, reduce complications, hospital stay, inadequate resources, provide epidemiological data, education and health prevention. Material and methods: Retrospective, observational and analytical study. A total of 150 patients with a clinical diagnosis acute infectious gastroenteritis, conventional laboratory studies and multiplex PCR, demographic variables, clinical history, empirical antibiotics, changes in medical management, hospital stay, complications, and infectious agents. Results: 64% were positive for a conventional test; 83% were adults and 17% children, a 1:1 ratio between men and women; minimum age of one month and maximum of 93 years. Sedentary lifestyle, adults over 65 years of age, prolonged hospital stay, and immunosuppression as comorbidities with 67%. 73% were given a conventional study upon admission. Presumptive diagnosis in 58%; initiation of empirical treatment in 72%. The multiplex PCR molecular test was positive for 76% with reports of one to six agents; pharmacological escalation in 25% and de-escalation in 33%, 37% who received no treatment or were suspended. Average hospital stay of 1.02 days. Recovery of 99% of patients and the implementation of preventive measures was 69%. Conclusions: The multiplex PCR panel showed high diagnostic performance, better details of the pathogen spectrum. With its use and proper application, it supported the reduction of hospital stay, complications, inappropriate use of antimicrobial therapies, education and health prevention.


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