{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:01:00Z","timestamp":1785765660414,"version":"3.56.0"},"reference-count":16,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: The QIAstat-Dx Gastrointestinal Panel (QGP), a rapid multiplex polymerase chain reaction (PCR) test, provides high diagnostic accuracy for ruling in common gastrointestinal pathogens. Its short turnaround time supports earlier therapeutic decisions and antibiotic stewardship, but its high cost highlights the need for more selective testing. This study aimed to develop a clinical score to identify paediatric patients most likely to have a positive bacterial QGP result. To our knowledge, no such score exists. Methods: We conducted a retrospective study including 70 paediatric patients (median age 1.08 years) who underwent QGP testing between April and October 2025 in a tertiary hospital in Bucharest, Romania. Clinical and biological variables, along with sonographic indicators of bowel inflammation, were evaluated for their association with positive bacterial QGP results. Results: No pathogens were detected in 40% of cases, a single pathogen was detected in 32.9% of samples, two pathogens in 21.4%, and three or more in 5.7%. Bacterial organisms were identified in 45.7% of tests, with Salmonella being most common (17.6% of all tests; 28.6% of positive tests). Of all evaluated variables, fever, bloody stools, C-reactive protein (CRP) &gt; 2 mg\/dL, sonographic evidence of bowel inflammation, and exclusion of other infectious foci were included in our prediction score, each assigned one point (with a maximum of 5 points). Other laboratory markers showed no significant association with a positive bacterial QGP result. Receiver operating characteristic (ROC) analysis yielded an area under the curve (AUC) of 0.758 (95% CI: 0.596\u20130.920, p = 0.005). The optimal cut-off, determined using Youden\u2019s index, was 2.5, with 80% sensitivity and 67.7% specificity. A score \u2265 3 indicated a markedly increased likelihood of a positive bacterial QGP result. Conclusions: The proposed QGP clinical score may support selective use of QGP testing, improving diagnostic efficiency and reducing unnecessary costs. Prospective multicentre validation is warranted.<\/jats:p>","DOI":"10.3390\/jcm15156020","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:57:56Z","timestamp":1785761876000},"page":"6020","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimising QIAstat-Dx Gastrointestinal Panel Use: Development of a Clinical Score to Predict Paediatric Bacterial Infections"],"prefix":"10.3390","volume":"15","author":[{"given":"Monica","family":"Ionescu","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Findrihan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Cristea","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Voicu","sequence":"additional","affiliation":[{"name":"National Institute for Mother and Child Health, 020395 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhea-Maria","family":"Macovei","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucharest, Romania"},{"name":"National Institute for Mother and Child Health, 020395 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Popp","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucharest, Romania"},{"name":"National Institute for Mother and Child Health, 020395 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Czika","sequence":"additional","affiliation":[{"name":"National Institute for Mother and Child Health, 020395 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1097\/MPG.0000000000000375","article-title":"European Society for Pediatric Gastroenterology, Hepatology, and Nutrition\/European Society for Pediatric Infectious Diseases Evidence-Based Guidelines for the Management of Acute Gastroenteritis in Children in Europe","volume":"59","author":"Guarino","year":"2014","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_2","unstructured":"Popescu, G.A., Pistol, A., Serban, R., Niculcea, A., and Leustean, M. (2022). Consumul de Antibiotice, Rezistenta Microbiana si Infectii Asociate Asistentei Medicale in Romania, INSP, Centrul National de Supraveghere si Control al Bolilor Transmisibile."},{"key":"ref_3","unstructured":"European Centre for Disease Prevention and Control (2025). Antimicrobial Consumption in the EU\/EEA (ESAC-Net)\u2014Annual Epidemiological Report for 2024, ECDC."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Iuhas, A., Gali\u0219, R., Rus, M., Petche\u0219i, C.D., Balmo\u0219, A., Marin\u0103u, C., Niula\u0219, L., Futaki, Z., Matioc, D., and Sava, C. (2025). Antibiotic Use in Pediatrics: Perceptions and Practices of Romanian Physicians. Antibiotics, 14.","DOI":"10.3390\/antibiotics14100976"},{"key":"ref_5","first-page":"e61979","article-title":"Gastrointestinal Panel Performance for the Diagnosis of Acute Gastroenteritis in Pediatric Patients","volume":"16","author":"Sameer","year":"2024","journal-title":"Cureus"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Alsuwaidi, A.R., Al Dhaheri, K., Al Hamad, S., George, J., Ibrahim, J., Ghatasheh, G., Issa, M., Al-Hammadi, S., and Narchi, H. (2021). Etiology of diarrhea by multiplex polymerase chain reaction among young children in the United Arab Emirates: A case-control study. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-020-05693-1"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Torres-Miranda, D., Akselrod, H., Karsner, R., Secco, A., Silva-Cantillo, D., Siegel, M.O., Roberts, A.D., and Simon, G.L. (2020). Use of BioFire FilmArray gastrointestinal PCR panel associated with reductions in antibiotic use, time to optimal antibiotics, and length of stay. BMC Gastroenterol., 20.","DOI":"10.1186\/s12876-020-01394-w"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"126","DOI":"10.3345\/kjp.2016.59.3.126","article-title":"Diagnostic value of the Vesikari Scoring System for predicting the viral or bacterial pathogens in pediatric gastroenteritis","volume":"59","author":"Shim","year":"2016","journal-title":"Korean J. Pediatr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e0198324","DOI":"10.1128\/jcm.01983-24","article-title":"Multicenter evaluation of the QIAstat-Dx Gastrointestinal Panel 2, a multiplex PCR platform for the diagnosis of acute gastroenteritis","volume":"63","author":"Szymczak","year":"2025","journal-title":"J. Clin. Microbiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"107","DOI":"10.5223\/pghn.2017.20.2.107","article-title":"Clinical Characteristics and Ultrasonographic Findings of Acute Bacterial Enterocolitis in Children","volume":"20","author":"Chun","year":"2017","journal-title":"Pediatr. Gastroenterol. Hepatol. Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"115611","DOI":"10.1016\/j.diagmicrobio.2021.115611","article-title":"Detection of potential enteric pathogens in children with severe acute gastroenteritis using the filmarray: Results from a three\u2014Years hospital-based survey in Northern Italy","volume":"102","author":"Buttrini","year":"2022","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Zizza, A., Guido, M., Sedile, R., Benelli, M., Nuzzo, M., Paladini, P., Romano, A., and Grima, P. (2024). A Multi-Pathogen Retrospective Study in Patients Hospitalized for Acute Gastroenteritis. Diseases, 12.","DOI":"10.3390\/diseases12090213"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s00431-024-05918-4","article-title":"The impact of multiplex nested gastrointestinal PCR panel in children with gastroenteridis requiring pediatric infectious disease consultation","volume":"184","author":"Kara","year":"2024","journal-title":"Eur. J. Pediatr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"116544","DOI":"10.1016\/j.diagmicrobio.2024.116544","article-title":"Detection of gastrointestinal pathogens in stool samples using a rapid multiplex PCR test at a large tertiary pediatric hospital","volume":"110","author":"Yasmin","year":"2024","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1136\/archdischild-2021-322465","article-title":"Clinical impact of a gastrointestinal PCR panel in children with infectious diarrhoea","volume":"107","author":"Truong","year":"2022","journal-title":"Arch. Dis. Child."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Yoo, I.H., Kang, H.M., Suh, W., Cho, H., Yoo, I.Y., Jo, S.J., Park, Y.J., and Jeong, D.C. (2021). Quality Improvements in Management of Children with Acute Diarrhea Using a Multiplex-PCR-Based Gastrointestinal Pathogen Panel. Diagnostics, 11.","DOI":"10.3390\/diagnostics11071175"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/6020\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:18:51Z","timestamp":1785763131000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/6020"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":16,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["jcm15156020"],"URL":"https:\/\/doi.org\/10.3390\/jcm15156020","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]}}}