Introduction. The identification of enteropathogens is critical for the clinical management of patients with suspected gastrointestinal infection. The FLOW multiplex PCR system (FMPS) is a semi-automated platform (FLOW System, Roche) for multiplex real-time PCR analysis. Hypothesis/Gap Statement. FMPS has greater sensitivity for the detection of enteric pathogens than standard methods such as culture, biochemical identification, immunochromatography or microscopic examination. Aim.The diagnostic performance of the FMPS was evaluated and compared to that of traditional microbiological procedures. Methodology. A total of 10 659 samples were collected and analysed over a period of 7 years. From 2013 to 2018 (every July to September), samples were processed using standard microbiological culture methods. In 2019, the FMPS was implemented using real-time PCR to detect the following enteropathogens: Shigella spp., Salmonella spp., Campylobacter spp., Giardia intestinalis, Entamoeba histolytica, Blastocystis hominis, Cryptosporidum spp., Dientamoeba fragilis, adenovirus, norovirus and rotavirus. Standard microbiological culture methods (2013–2018) included stool culture, microscopy and immunochromatography. Results. A total of 1078 stool samples were analysed prospectively using the FMPS from July to September (2019): bacterial, parasitic and viral pathogens were identified in 15.3, 9.71 and 5.29 % of cases, respectively. During the same period of 6 years (2013–2018), the proportion of positive identifications using standard microbiological methods from 2013 to 2018 was significantly lower. A major significant recovery improvement was observed for all bacteria species tested: Shigella spp./enteroinvasive Escherichia coli (EIEC) (P <0.05), Salmonella spp. (P <0.05) and Campylobacter spp. (P <0.05). Marked differences were also observed for the parasites G. intestinalis, Cryptosporidium spp. and D. fragilis. Conclusion. These results support the value of multiplex real-time PCR analysis for the detection of enteric pathogens in laboratory diagnosis with outstanding performance in identifying labile micro-organisms. The identification of unsuspected micro-organisms for less specific clinical presentations may also impact on clinical practice and help optimize patient management.

中文翻译：

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使用半自动多重实时 PCR 检测肠道病原体改进胃肠道感染的诊断

介绍。肠道病原体的鉴定对于疑似胃肠道感染患者的临床管理至关重要。FLOW 多重 PCR 系统 (FMPS) 是用于多重实时 PCR 分析的半自动化平台（FLOW System，Roche）。假设/差距陈述。与培养、生化鉴定、免疫层析或显微镜检查等标准方法相比，FMPS 对肠道病原体的检测具有更高的灵敏度。目的。对 FMPS 的诊断性能进行了评估，并与传统微生物程序的诊断性能进行了比较。方法。在 7 年的时间里，共收集和分析了 10 659 个样本。从 2013 年到 2018 年（每年 7 月到 9 月），使用标准微生物培养方法处理样品。2019 年，FMPS 使用实时 PCR 检测以下肠道病原体：志贺氏菌属。, 沙门氏菌属。, 弯曲杆菌属,贾第鞭毛虫, 溶组织内阿米巴, 人芽孢杆菌, 隐孢子虫属。、脆弱的土阿米巴、腺病毒、诺如病毒和轮状病毒。标准微生物培养方法（2013-2018）包括粪便培养、显微镜检查和免疫层析。结果。 从 7 月至 9 月（2019 年），使用 FMPS 对总共 1078 份粪便样本进行了前瞻性分析：分别在 15.3%、9.71% 和 5.29% 的病例中发现了细菌、寄生虫和病毒病原体。6年同期（2013-2018年），2013-2018年使用标准微生物方法鉴定阳性的比例明显较低。观察到所有测试的细菌种类都有重大的显着恢复改善：志贺氏菌属/肠侵袭性大肠杆菌(EIEC) ( P <0.05)，沙门氏菌属。( P <0.05) 和弯曲杆菌属。( P <0.05)。寄生虫也观察到显着差异 G.肠道菌，隐孢子虫属。和D. fragilis。结论。这些结果支持多重实时 PCR 分析在实验室诊断中检测肠道病原体的价值，在识别不稳定微生物方面表现突出。针对不太具体的临床表现识别出未经怀疑的微生物也可能影响临床实践并帮助优化患者管理。