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Infectious Causes for Gastrointestinal Illness in Pediatric Patients

Syndromic Testing: Distinguishing the Cause of Gastrointestinal Illness in Pediatric Patients

Gastrointestinal illnesses in pediatric patients are common but concerning for their parents. Parents want solid answers they can act on, and the best way to get them those answers? Syndromic testing.

Gastroenteritis is an inflammation of the gastrointestinal tract and is often caused by infectious agents, including bacteria, viruses, and parasites. With symptoms including diarrhea, nausea, vomiting, and/or abdominal cramps, the underlying cause may not be determined by clinical presentation alone.

Gastrointestinal illness has a big impact in the United States and globally:

  • Each year, approximately 179 million episodes of acute gastroenteritis occur in the United States among the general population (adults and children)1
  • In the United States, foodborne diarrheal illness results in more than 128,000 hospitalizations and 3,000 deaths among adults each year2
  • Diarrhea is the leading cause of malnutrition in children under the age of 5 globally3

Importance of Distinguishing Cause of Pediatric Gastroenteritis

In most cases, pediatric acute gastrointestinal illness is a short, self-limiting illness that usually does not require treatment. However, pediatric patients are a sensitive group that can experience complications from a gastrointestinal illness, particularly if the illness is caused by C. difficile or a parasite. And pediatric patients can't always verbalize their symptoms, making the diagnosis even more of a guessing game.

In an interview, Dr. Samuel Dominguez, a pediatric infectious disease physician, explained the role and importance of distinguishing pathogens in cases of pediatric gastroenteritis. "Some providers use GI testing to 'rule out' a serious GI infection. For example, a child with a history of inflammatory bowel disease might present with new-onset bloody diarrhea and testing for GI pathogens might help determine if this is due to the acquisition of a new infection versus a flare of their underlying condition. Diagnosing a GI pathogen can also be extremely helpful for epidemiologic purposes to identify the cause of an outbreak, find an etiology in a complicated patient that might prevent further testing or, less commonly, to find an etiology to reassure patients that this should be a self-limited disease."4

Unfortunately, traditional stool testing methods don't always give clinicians the information they need. Challenges with traditional testing include:

  • Long turnaround times
  • Labor intensiveness
  • Poor sensitivity
  • Required expertise (particularly for ova and parasite exams)
  • Possible complex and confusing ordering strategies
  • Multiple tests add expenses
  • Different etiologies of infectious gastroenteritis have similar clinical presentations

The Role of the Syndromic Approach

There are many challenges when it comes to testing pediatric patients for a gastrointestinal illness. Using the syndromic approach, the multiplex PCR BIOFIRE® FILMARRAY® Gastrointestinal (GI) Panel offers results on a comprehensive menu of 22 common gastrointestinal targets. With results in about an hour, the BioFire GI Panel takes the guesswork out of deciding which pathogens to test for.

Because traditional stool testing methods are slow and lack sensitivity, clinicians often have to make patient management decisions without a laboratory result. Syndromic testing from the BIOFIRE GI Panel offers fast sample-to-answer turnaround and accurate results, which can help:

  • Reduce antibiotic use5
  • Reduce time to antimicrobial therapy6
  • Lead to more targeted therapy6
  • Reduce downstream procedures such as endoscopies and abdominal imaging5

Discover more about syndromic gastrointestinal testing:

References

  1. Wikswo ME, et al. CDC. Morbidity and Mortality Weekly Report. 2015. Accessed on 26 May 2022. Retrieved from: https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6412a1.htm.
  2. Barr W. Am Fam Physician. 2014;89(3):180-189.
  3. WHO. Diarrhoeal disease. 2017. Accessed on 26 May 2022. Retrieved from:  https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease
  4. .SelectScience. Syndromic testing: Achieving better clinical outcomes for gastrointestinal pediatric patients. Accessed on 02 June 2022. Retrieved from: https://www.selectscience.net/editorial-articles/syndromic-testing-achieving-better-clinical-outcomes-for?artID=54861
  5. Axelrad JE, et al. J of Clin. Microbiology. 2019; 27;57(3). e01775-18.
  6. Cybulski R, et al. 2018. Clinical Infectious Diseases, ciy357.

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