Fofiu Crina, Dobru Daniela, Andone Adina, Nyulas Victoria Ancuța, Boeriu Alina
Gstroenterology Department, University of Medicine Pharmacy, Sciences, and Technology "George Emil Palade" Targu Mures, 540142 Targu Mures, Romania.
Internal Medicine Department, Bistrița Clinical County Emergency Hospital, 420094 Bistrița, Romania.
Biomedicines. 2025 May 9;13(5):1155. doi: 10.3390/biomedicines13051155.
: Acute diarrheal illnesses are a major cause of hospital admissions, particularly in immunocompromised patients. Traditional diagnostic methods are slow and often insensitive, delaying treatment. In contrast, PCR panels provide rapid, sensitive detection of multiple pathogens. This study evaluates stool PCR testing in hospitalized adults and its impact on clinical decisions and antimicrobial stewardship. : We conducted a retrospective study at Bistrița County Hospital, Romania (September 2023-September 2024), including 75 adults with acute diarrhea and negative conventional stool tests. PCR testing (VIASURE panels I and II) detected 11 bacteria, 6 viruses, and 5 parasites. Clinical and therapeutic data were analyzed, and logistic regression identified predictors of PCR positivity and adverse outcomes. : PCR was positive in 78% of cases, with spp. (57.6%) and (20.3%) being the most common. Bloody diarrhea independently predicted PCR positivity (OR 9.78, = 0.047). Immunosuppression and end-stage liver disease were linked to worse outcomes. PCR results led to antimicrobial therapy adjustments in 40 patients ( = 0.001), correcting inappropriate antibiotic use in 66% of those receiving empirical treatment. Targeted therapy significantly reduced antimicrobial duration from 7 to 5 days ( = 0.00001). : Stool PCR testing enhances pathogen detection, guides targeted therapy, and reduces inappropriate antibiotic use, supporting antimicrobial stewardship and improving outcomes in selected hospitalized patients.
急性腹泻病是住院的主要原因，尤其是在免疫功能低下的患者中。传统的诊断方法速度慢且往往不敏感，会延误治疗。相比之下，聚合酶链反应（PCR）检测板能快速、灵敏地检测多种病原体。本研究评估了住院成人粪便PCR检测及其对临床决策和抗菌药物管理的影响。
我们在罗马尼亚比斯特里察县医院进行了一项回顾性研究（2023年9月至2024年9月），纳入了75名患有急性腹泻且常规粪便检测结果为阴性的成人。PCR检测（VIASURE检测板I和II）检测出11种细菌、6种病毒和5种寄生虫。对临床和治疗数据进行了分析，逻辑回归确定了PCR阳性和不良结局的预测因素。
78%的病例PCR呈阳性，其中 菌属（57.6%）和 （20.3%）最为常见。血性腹泻独立预测PCR阳性（比值比9.78， = 0.047）。免疫抑制和终末期肝病与更差的结局相关。PCR结果导致40例患者的抗菌治疗调整（ = 0.001），在接受经验性治疗的患者中，66%的患者纠正了不适当的抗生素使用。靶向治疗显著缩短了抗菌治疗时间，从7天降至5天（ = 0.00001）。
粪便PCR检测可提高病原体检测能力，指导靶向治疗，减少不适当的抗生素使用，支持抗菌药物管理并改善部分住院患者的结局。
