{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T10:18:51Z","timestamp":1783678731418,"version":"3.55.0"},"reference-count":38,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"EU funding","award":["PE00000007"],"award-info":[{"award-number":["PE00000007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>This retrospective study, conducted between September 2023 and October 2025, evaluated age-related pathogen prevalence, seasonal dynamics, and Cycle threshold (Ct) values in nasopharyngeal specimens from hospitalized subjects with suspected acute respiratory infections (ARIs) using the multiplex syndromic panel. A median-based Delta Ct was calculated to define pathogen dominance in co-detections. A total of 2479 nasopharyngeal swabs were analyzed and 54.4% tested positive for at least one pathogen. Overall, the positivity rate and co-detections were found to be significantly higher in pediatric group than in the adult one (p &lt; 0.0001 and p &lt; 0.0001, respectively). Semi-quantitative analysis revealed that RSV and flu viruses maintained low Ct values irrespective of co-detection, whereas RV\/EV, Adv, and human bocavirus (HBoV) exhibited significantly higher Ct values when co-detected. RV\/EV showed higher Ct values versus human metapneumovirus A\/B (p = 0.0014), human parainfluenza virus (p = 0.0007), flu virus (p = 0.0084) and RSV (p &lt; 0.0001). Likewise, Adv demonstrated higher Ct values in comparison to RSV (p = 0.0046). Seasonal drivers typically dominate over persistent agents. Integrating semi-quantitative interpretation into syndromic panel reporting could enhance diagnostic stewardship, optimize antimicrobial use, and improve resource allocation in high-pressure clinical settings.<\/jats:p>","DOI":"10.3390\/microorganisms14071450","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:50:37Z","timestamp":1782867037000},"page":"1450","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnosis of Respiratory Infections Using Syndromic Panels: A Ct-Based Approach Beyond Qualitative Detection"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9479-8559","authenticated-orcid":false,"given":"Maria Antonella","family":"Zingaropoli","sequence":"first","affiliation":[{"name":"Microbiology and Virology Unit, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca Bruno","family":"Tassone","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, Sapienza University of Rome, 00141 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Coratti","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, Sapienza University of Rome, 00141 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella Maria","family":"Rodio","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Bernassola","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7381-9071","authenticated-orcid":false,"given":"Roberta","family":"Campagna","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, Sapienza University of Rome, 00141 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucilla","family":"Caivano","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, Sapienza University of Rome, 00141 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Pulcinelli","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Infantile Neuropsychiatry, Sapienza University of Rome, 00141 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Midulla","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Infantile Neuropsychiatry, Sapienza University of Rome, 00141 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gioacchino","family":"Galardo","sequence":"additional","affiliation":[{"name":"Department of Medical and Cardiovascular Sciences, Sapienza University of Rome, 00141 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0633-360X","authenticated-orcid":false,"given":"Alessandra","family":"Pierangeli","sequence":"additional","affiliation":[{"name":"Department of Well-being, Health and Environmental Sustainability (BeSSA), Sapienza University of Rome, 02100 Rieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2533-2939","authenticated-orcid":false,"given":"Guido","family":"Antonelli","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, Sapienza University of Rome, 00141 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6400-9168","authenticated-orcid":false,"given":"Ombretta","family":"Turriziani","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, Sapienza University of Rome, 00141 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e00024-17","DOI":"10.1128\/CMR.00024-17","article-title":"Syndromic Panel-Based Testing in Clinical Microbiology","volume":"31","author":"Ramanan","year":"2018","journal-title":"Clin. 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