{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:20:31Z","timestamp":1791872431929,"version":"4.3.4"},"reference-count":17,"publisher":"American Society for Microbiology","issue":"7","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Diasorin"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2025,7,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Extended respiratory panels have been limited to specific patient populations due to cost and inconclusive clinical utility. Customizing syndromic panels offers a way to balance clinical utility and available resources. In this study, we evaluated strategies and assessed the value of flexible, customized respiratory panels. A total of 200 specimens from symptomatic patients (December 2023 to September 2024), negative for SARS-CoV-2\/Flu\/RSV, were tested with the LIAISON PLEX Respiratory Flex Assay\u2014an extended respiratory panel that offers flexibility in target selection. The study assessed additional diagnoses, correlations with institutional and state-wide pathogen prevalence, and whether customizable panels could optimize diagnostic yield. Sixty-two samples (31%) negative for SARS-CoV-2\/Flu\/RSV tested positive for other targets, primarily rhinovirus\/enterovirus (60%), correlating with local and state prevalence. Weighted estimates for 18,373 symptomatic patients during the study period modeled a prevalence of 14.3% for rhinovirus\/enterovirus, followed by HPIV-3, adenovirus, and coronavirus. During the study period, 6% of patients received the standard of care extended respiratory panel order after a negative SARS-CoV-2\/Flu\/RSV result, duplicating SARS-CoV-2\/Flu\/RSV testing. Leveraging a flexible feature could have resulted in an estimated staff time reduction of 5,545 minutes for a second swab collection and running a second test, in addition to the cost of running two different panels during a single encounter. Local respiratory pathogen prevalence data can guide target selection in customized panels. The inclusion of high-prevalence targets can increase the likelihood of diagnosis from 12% to nearly 30%. Flexibility in customizing targeted pathogen panels could enhance diagnostic value while conserving institutional resources.<\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>Rapid and accurate identification of pathogens causing respiratory tract infections can aid in guiding treatment decisions, reducing healthcare costs, and supporting real-time surveillance of infectious diseases within a community. Limitations of clinical utility beyond SARS-CoV-2\/Flu\/RSV are primarily driven by cost and the lack of specific treatment options. There is a need to balance clinical gaps with testing cost and diagnostic stewardship. In this study, we evaluated the utility of flexible, customized respiratory viral panels and reportable targets within a broader set of available targets in an extended respiratory panel.<\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/jcm.00313-25","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T09:01:11Z","timestamp":1749546071000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":6,"title":["The utility of syndromic respiratory pathogen panels: the premise of flexible and customizable approaches"],"prefix":"10.1128","volume":"63","author":[{"given":"Julie M.","family":"Norton","sequence":"first","affiliation":[{"name":"Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaby","family":"Dashler","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Johns Hopkins School of Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1304-5289","authenticated-orcid":false,"given":"Eili","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Johns Hopkins School of Medicine","place":["Baltimore, USA"]},{"id":[{"id":"https:\/\/ror.org\/05fcqx592","id-type":"ROR","asserted-by":"publisher"}],"name":"Center for Disease Dynamics, Economics, and Policy","place":["Washington, DC, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0274-8966","authenticated-orcid":true,"given":"Heba H.","family":"Mostafa","sequence":"additional","affiliation":[{"name":"Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.01116-24"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/jalm\/jfae010"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.03368-12"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2021.104737"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02955-20"},{"key":"e_1_3_3_7_2","unstructured":"Maryland Department of Health. Maryland select respiratory pathogen testing surveillance. Available from: https:\/\/health.maryland.gov\/phpa\/influenza\/fluwatch\/Pages\/Select-Respiratory-Pathogen-Testing-Surveillance.aspx. Accessed 8 January 2025"},{"key":"e_1_3_3_8_2","unstructured":"CDC. Influenza-associated pediatric mortality. Available from: https:\/\/gis.cdc.gov\/GRASP\/Fluview\/PedFluDeath.html. Accessed 8 January 2025"},{"key":"e_1_3_3_9_2","unstructured":"CDC. Respiratory syncytial virus infection (RSV). Available from: https:\/\/www.cdc.gov\/rsv\/php\/surveillance\/rsv-net.html. 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