Syndromic panel testing- Understanding Epidemiology of paediatric diarrhoea to augment antimicrobial stewardship in tertiary health care set-up.

Purpose: This study was undertaken to know the epidemiology of various microorganisms causing gastroenteritis in paediatric age group, to evaluate clinico-microbiological correlation with respect to the type of microorganism, to study the clinical presentations and impact of syndromic based film array assay on antimicrobial stewardship and patient management.

Methods: This is five years retrospective study in which the results of Gastrointestinal film array panel of stool specimens of children <=16 Years of age who presented with gastroenteritis during 2019 to 2023 were noted. Clinical correlation of the microbes was done with respect to suspected clinical diagnosis, age, immune status and other underlying illness.

Results: Out of 151 samples, 41 were negative for all the pathogens and 110 showed presence of one or more pathogens. The occurrence of negative Film array assay in immunocompromised patients was observably more in comparison to immunocompetent patients (36.36% vs 23.36%). Rota virus A and Shigella/Enteroinvasive Escherichia coli (EIEC) were statistically (p value <=0.05) more often detected in immunocompetent patients and children below 5 years of age. The detection of Clostridioides difficile toxin A/B was mainly attributed to transient colonization or asymptomatic carriage in young children. Giardia lamblia and Entamoeba histolytica were more often detected in immunocompetent children. Amongst viruses, Norovirus was detected maximally.

Conclusions: Syndromic panel-based detection of pathogens can help in understanding epidemiology of infections, antimicrobial stewardship, setting an example for diagnostic stewardship and may act as a good tool for surveillance of infections thereby leading to timely initiation of preventive strategies.