Department of Laboratory Medicine, AZ Delta, Roeselare, Belgium.
Department of Laboratory Medicine, Sint-Andries Hospital, Tielt, Belgium.
Eur J Clin Microbiol Infect Dis. 2024 Mar;43(3):435-443. doi: 10.1007/s10096-023-04739-x. Epub 2023 Dec 26.
The aim of the study was to determine and evaluate the clinical usefulness of pathogen specific semi-quantitative cut-offs in stool samples with multiple pathogen detections.
The PCR (Seegene Allplex Gastrointestinal Virus Assay) data from 4527 positive samples received over 16 months were retrospectively analyzed to investigate the distribution of the Ct values of each individual viral pathogen. By using interquartile ranges for each viral pathogen, pathogen specific semi-quantitative cut-offs were determined.
After a thorough analysis of the Ct values, a well-founded decision to exclude all results with a Ct value higher than 35 was made. This approach made it possible to generate a more nuanced report and to facilitate clinical interpretation in case of mixed infections by linking a lower Ct value of a pathogen to a greater likelihood of being a relevant causative pathogen. Moreover, not reporting viral pathogens with a Ct value higher than 35 led to a significant reduction (p < 0.0001) of reported mixed infections compared to oversimplified qualitative or qualitative reporting.
By omitting very high Ct values and reporting semi-quantitatively, value was added to the syndromic reports, leading to an easier to read lab report, especially in mixed infections.
本研究旨在确定和评估在多重病原体检测的粪便样本中病原体特异性半定量截止值的临床实用性。
对 16 个月内收到的 4527 份阳性样本的 PCR（Seegene Allplex 胃肠道病毒检测）数据进行回顾性分析，以研究每个单独病毒病原体的 Ct 值分布。通过使用每个病毒病原体的四分位间距，确定病原体特异性半定量截止值。
在对 Ct 值进行彻底分析后，做出了一个合理的决定，排除所有 Ct 值高于 35 的结果。这种方法可以生成更细致的报告，并在混合感染的情况下通过将病原体的较低 Ct 值与更有可能成为相关致病病原体联系起来，方便临床解释。此外，不报告 Ct 值高于 35 的病毒病原体，与过于简化的定性或定性报告相比，报告的混合感染显著减少（p<0.0001）。
通过省略非常高的 Ct 值并进行半定量报告，为综合征报告增加了价值，使实验室报告更易于阅读，尤其是在混合感染的情况下。
