Retrospective analysis of multiplex panel tests in the diagnosis of respiratory tract infections

Abstract

Respiratory tract infections (RTIs) remain a major global health concern, particularly in children. The overlapping clinical manifestations of RTIs highlight the need for rapid and accurate diagnostic methods such as multiplex PCR (mPCR). This retrospective single-center study investigated the epidemiology of respiratory pathogens detected by mPCR, focusing on their distribution, age-related patterns, seasonal variation, and coinfections. Nasopharyngeal swab samples from 328 patients with suspected acute RTIs, collected between January 2022 and December 2023, were analyzed using the BioFire FilmArray Respiratory Panel 2.1. Demographic characteristics, clinical findings, pathogen distribution, seasonal trends, and coinfections were evaluated. At least one respiratory pathogen was detected in 270 of 328 specimens, yielding an overall positivity rate of 82.3%. Viral pathogens predominated; human rhinovirus/enterovirus HRV/HEV (28%), adenovirus (21.8%), respiratory syncytial virus (RSV) (14.2%), and influenza viruses (11.3%) were the most frequently identified agents. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and human metapneumovirus (HMPV) were detected in 6.8% and 5.8% of cases, respectively. The vast majority of specimens (91.5%) were from pediatric patients (0–18 years). Coinfections were identified in 31.8% of positive cases, most commonly involving adenovirus and HRV/HEV. Seasonal analysis demonstrated a marked increase in positivity during winter and spring months, accounting for 74% of all positive cases. Bacterial pathogens were rarely detected. mPCR demonstrated high diagnostic value, with pathogens detected in 82.3% of samples, predominantly viral agents. These findings support the role of mPCR in improving diagnostic accuracy and providing valuable regional epidemiological data. Rapid identification of viral pathogens may also support antimicrobial stewardship by facilitating more informed clinical decision-making; however, antibiotic utilization was not evaluated in the present study.