Multicenter evaluation of the new QIAstat Gastrointestinal Panel for the rapid syndromic testing of acute gastroenteritis

Eur J Clin Microbiol Infect Dis. 2019 Nov;38(11):2103-2112. doi: 10.1007/s10096-019-03646-4. Epub 2019 Jul 27.

Abstract

In acute gastroenteritis (AGE), identification of the infectious agent is important for patient management. Since symptoms do not reliably identify the agent, microbiological diagnostics are important. Conventional methods lack sensitivity and often take days. Multiplex PCR panels offer fast and sensitive alternatives. Our aim was to assess the performance of the new QIAstat Gastrointestinal Panel (GIP) detecting 24 different gastroenteric pathogens from stool in Cary-Blair transport medium (Adenovirus F 40/41, Astrovirus, Norovirus GI/GII, Rotavirus A, Sapovirus, Campylobacter spp., Clostridium difficile, Plesiomonas shigelloides, Salmonella spp., Vibrio cholera, Vibrio parahaemolyticus, Vibrio vulnificus, Yersinia enterocolitica, enteroaggregative Escherichia coli, enteropathogenic E. coli, enterotoxigenic E. coli, Shiga-toxin-producing E. coli (stx1 and stx2) (including specific detection of E. coli O157), Shigella spp./enteroinvasive E. coli, Cryptosporidium spp., Cyclospora cayetanensis, Entamoeba histolytica and Giardia lamblia). We tested both prospective (n = 163) and retrospective (n = 222) stool samples sent for routine diagnostics by the QIAstat GIP comparing it to the FDA-approved BioFire FilmArray GIP. Seegene Allplex GIP was used for discrepancy testing. After discrepancy testing, QIAstat GIP detected 447 of 455 pathogens (98.2%, 95% confidence interval (CI) 96.6-99.1%). There were eight false positive detections. Multiple pathogens were detected in 32.5% of positive samples. The QIAstat GIP detected a large range of AGE pathogens with a high sensitivity. It offers an easy-to-use system for GI pathogen detection in stool within 70 min. An advantage of the QIAstat is the availability of cycle threshold (CT) values to aid in interpretation of results.

Keywords: Diarrhoea; Gastrointestinal pathogens; Laboratory diagnosis; Molecular assay; Multiplex PCR; Syndromic testing.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Animals
  • Bacteria / classification
  • Bacteria / isolation & purification*
  • Child
  • Child, Preschool
  • Feces / microbiology
  • Feces / parasitology
  • Feces / virology
  • Female
  • Gastroenteritis / diagnosis*
  • Humans
  • Infant
  • Infant, Newborn
  • Middle Aged
  • Molecular Diagnostic Techniques / standards*
  • Multiplex Polymerase Chain Reaction
  • Parasites / classification
  • Parasites / isolation & purification*
  • Prospective Studies
  • Retrospective Studies
  • Sensitivity and Specificity
  • Time Factors
  • Viruses / classification
  • Viruses / isolation & purification*
  • Young Adult