Aetiological diagnosis of gastrointestinal infections is challenging since a wide range of bacteria, parasites and viruses can be causal agents and derived clinical manifestations appear quite similar. Our aim was to evaluate contribution of the novel QIAstat-DxGastrointestinal Panel (GIP) to aetiological diagnosis of gastrointestinal infections and rational antimicrobial prescription in a reference paediatric hospital. Evaluation included comparison of diagnostic yield and agreement of results of QIAstat-Dx GIP and conventional microbiological methods. Parallel testing was performed on stool samples collected prospectively from children admitted to Sant Joan de Deu Barcelona Hospital (Spain) during the period February–March 2019. Influence of the panel test use on antimicrobial prescription was assessed using a pre–post study design. Eighty-six (68.8%) out of 125 specimens were positive by QIAstat-Dx GIP versus 44 (35.2%) positive by a composite of conventional methods (p<0.001). Global agreement of panel test results with rotavirus-adenovirus antigen detection (92.8%) and a two-step antigen/toxin and PCR-based algorithm for toxigenic Clostridioides difficile detection (87.5%) was greater than that with bacterial culture (76.0%) and parasite microscopic identification (64.3%). Panel test results orientated antimicrobial prescription changes in 18 (14.4%) patients, including antimicrobial start in 11 cases initially untreated, targeted antimicrobial prescription in 5 and discontinuation in 2 cases empirically treated. Results showed that QIAstat-Dx GIP significantly expanded aetiological diagnosis of gastrointestinal infections compared to conventional microbiological methods while orientating a more judicious use of antimicrobial drugs in hospitalised children.

胃肠道感染的病因学诊断具有挑战性，因为多种细菌、寄生虫和病毒都可能是病原体，并且衍生的临床表现非常相似。我们的目的是评估新型 QIAstat-DxGastrointestinal Panel (GIP) 对参考儿科医院胃肠道感染的病原学诊断和合理抗菌处方的贡献。评估包括比较诊断率以及 QIAstat-Dx GIP 和传统微生物方法结果的一致性。对 2019 年 2 月至 3 月期间从巴塞罗那 Sant Joan de Deu 医院（西班牙）收治的儿童前瞻性收集的粪便样本进行了平行测试，并使用事前研究设计评估了小组测试使用对抗菌药物处方的影响。 125 份样本中，QIAstat-Dx GIP 检测结果有 86 份 (68.8%) 呈阳性，而综合传统方法检测结果为 44 份 (35.2%) 呈阳性 ( p <0.001)。轮状病毒-腺病毒抗原检测 (92.8%) 和基于两步抗原/毒素和 PCR 的产毒艰难梭菌检测算法 (87.5%) 的小组测试结果的总体一致性高于细菌培养 (76.0%) 和寄生虫显微镜鉴定（64.3%）。小组测试结果显示 18 例（14.4%）患者的抗菌药物处方发生变化，其中 11 例最初未接受治疗的患者开始使用抗菌药物，5 例有针对性地处方抗菌药物，2 例经经验治疗后停用抗菌药物。 结果显示，与传统微生物学方法相比，QIAstat-Dx GIP 显着扩大了胃肠道感染的病因诊断范围，同时指导住院儿童更明智地使用抗菌药物。