这项研究的目的是调查综合征诊断测试的价值,以更好地了解丹麦胃肠道感染的流行病学。在这里,我们评估了QIAstat-Dx®胃肠道(GI)小组1对18,610个粪便样品的分析要求,以分析新西兰地区的肠道病原体,丹麦,1年(2021年10月1日至2022年9月30日)。总的来说,6905(37%)个样本检测出一种或多种腹泻细菌呈阳性,病毒,和原生动物.最常见的细菌,病毒,使用QIAstat-Dx®胃肠道面板1检测到的寄生虫病原体为EPEC(年龄≥2岁的患者)(n=1420(20.6%)),轮状病毒(n=948(13.7%)),和隐孢子虫。(n=196(2.84%))。我们发现感染的多样性很大,可能反映了流行病学的实质性差异,包括感染的起源。传输模式,季节性,年龄依赖性疾病易感性,严重程度,和旅行历史。所有病原体均被检测为单一感染和合并感染。病毒感染在3月份达到高峰,阳性率为31.6%,细菌感染在8月份达到高峰,阳性率为35.3%。ETEC,志贺氏菌/EIEC,EAEC,shigelloides与旅行活动最相关,合并感染频繁。病原体之间的Ct值分布差异显著,在星状病毒中观察到的最低Ct值(中位数17-18),腺病毒,和轮状病毒。我们的结果强调了对粪便样本进行广泛诊断测试以充分检测相关腹泻病原体以实现最佳临床护理的价值。
The aim of this study was to investigate the value of syndromic diagnostic testing for a better understanding of the epidemiology of gastrointestinal infections in Denmark. Here we evaluated the QIAstat-Dx® Gastrointestinal (GI) Panel 1 assay on 18,610 fecal samples requested for analysis for enteric pathogens in Region Zealand, Denmark, in 1 year (October 1, 2021, to September 30, 2022). In total, 6905 (37%) samples were detected positive for one or more diarrhoeal bacteria, viruses, and protozoa. The most common bacterial, viral, and parasitic pathogens detected with the QIAstat-Dx® Gastrointestinal Panel 1 were EPEC (in patients ≥ 2 years of age) (n = 1420 (20.6%)), rotavirus (n = 948 (13.7%)), and Cryptosporidium spp. (n = 196 (2.84%)). We identified a large diversity in infections likely reflecting substantial differences in the epidemiology including origin of infections, mode of transmission, seasonality, age-dependent susceptibility to disease, severity, and travel history. All pathogens were detected as both single and coinfections. Viral infections peaked in March with a positive rate of 31.6%, and bacterial infections peaked in August with a positive rate of 35.3%. ETEC, Shigella/EIEC, EAEC, and P. shigelloides were most related to travel activity, and coinfections were frequent. The distribution of Ct values varied significantly between the pathogens, with the lowest Ct values (median 17-18) observed in astrovirus, adenovirus, and rotavirus. Our results highlight the value of providing extensive diagnostic testing on fecal samples for sufficient detection of relevant diarrhoeal pathogens for optimal clinical care.