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Enteric Pathogen Testing Importance for Children with Acute Gastroenteritis: a Modified Delphi Study

The application of clinical diagnostics for gastroenteritis in children has implications for a broad collection of stakeholders, impacting clinical care, communicable disease control, and laboratory utilization. To support diagnostic stewardship as gastroenteritis testing options continue to advance...

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Autores principales: Tarr, Gillian A. M., Persson, Drew J., Tarr, Phillip I., Freedman, Stephen B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society for Microbiology 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9602993/
https://www.ncbi.nlm.nih.gov/pubmed/36125298
http://dx.doi.org/10.1128/spectrum.01864-22
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author Tarr, Gillian A. M.
Persson, Drew J.
Tarr, Phillip I.
Freedman, Stephen B.
author_facet Tarr, Gillian A. M.
Persson, Drew J.
Tarr, Phillip I.
Freedman, Stephen B.
author_sort Tarr, Gillian A. M.
collection PubMed
description The application of clinical diagnostics for gastroenteritis in children has implications for a broad collection of stakeholders, impacting clinical care, communicable disease control, and laboratory utilization. To support diagnostic stewardship as gastroenteritis testing options continue to advance, it is critical to understand which enteropathogens constitute priorities for testing across stakeholder groups. Using a modified Delphi technique, we elicited opinions of subject matter experts to determine clinical and public health testing priorities. There was a high level of overall agreement (≥80%) among stakeholders (final round n = 15) that testing was important for Campylobacter, Escherichia coli O157 and other Shiga toxin-producing E. coli, Salmonella, Shigella, Vibrio, Yersinia, norovirus, and rotavirus. Immunocompromised children were identified as a special population that warranted the additional testing of three to four bacterial and parasitic targets. To support these clinical and public health testing priorities, diagnostic stewardship strategies can be employed, such as educating clinicians, developing new decision support tools, and using multiplex testing in concert with selective result reporting and annotation. IMPORTANCE Children with diarrhea and vomiting who seek care can be infected with a wide variety of infectious agents. This study reports findings from a survey of clinical, public health, and laboratory subject matter experts on the infectious agents that are most important to test for. The majority agreed on the importance of testing children likely infected with several bacterial agents, as well as two common viruses. Although confirming a child is positive for a viral agent is unlikely to change clinical care, participants noted the importance of monitoring these viruses for public health purposes. To avoid over-testing children, however, these results should be used to support diagnostic stewardship strategies and design new decision support tools.
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spelling pubmed-96029932022-10-27 Enteric Pathogen Testing Importance for Children with Acute Gastroenteritis: a Modified Delphi Study Tarr, Gillian A. M. Persson, Drew J. Tarr, Phillip I. Freedman, Stephen B. Microbiol Spectr Research Article The application of clinical diagnostics for gastroenteritis in children has implications for a broad collection of stakeholders, impacting clinical care, communicable disease control, and laboratory utilization. To support diagnostic stewardship as gastroenteritis testing options continue to advance, it is critical to understand which enteropathogens constitute priorities for testing across stakeholder groups. Using a modified Delphi technique, we elicited opinions of subject matter experts to determine clinical and public health testing priorities. There was a high level of overall agreement (≥80%) among stakeholders (final round n = 15) that testing was important for Campylobacter, Escherichia coli O157 and other Shiga toxin-producing E. coli, Salmonella, Shigella, Vibrio, Yersinia, norovirus, and rotavirus. Immunocompromised children were identified as a special population that warranted the additional testing of three to four bacterial and parasitic targets. To support these clinical and public health testing priorities, diagnostic stewardship strategies can be employed, such as educating clinicians, developing new decision support tools, and using multiplex testing in concert with selective result reporting and annotation. IMPORTANCE Children with diarrhea and vomiting who seek care can be infected with a wide variety of infectious agents. This study reports findings from a survey of clinical, public health, and laboratory subject matter experts on the infectious agents that are most important to test for. The majority agreed on the importance of testing children likely infected with several bacterial agents, as well as two common viruses. Although confirming a child is positive for a viral agent is unlikely to change clinical care, participants noted the importance of monitoring these viruses for public health purposes. To avoid over-testing children, however, these results should be used to support diagnostic stewardship strategies and design new decision support tools. American Society for Microbiology 2022-09-20 /pmc/articles/PMC9602993/ /pubmed/36125298 http://dx.doi.org/10.1128/spectrum.01864-22 Text en Copyright © 2022 Tarr et al. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research Article
Tarr, Gillian A. M.
Persson, Drew J.
Tarr, Phillip I.
Freedman, Stephen B.
Enteric Pathogen Testing Importance for Children with Acute Gastroenteritis: a Modified Delphi Study
title Enteric Pathogen Testing Importance for Children with Acute Gastroenteritis: a Modified Delphi Study
title_full Enteric Pathogen Testing Importance for Children with Acute Gastroenteritis: a Modified Delphi Study
title_fullStr Enteric Pathogen Testing Importance for Children with Acute Gastroenteritis: a Modified Delphi Study
title_full_unstemmed Enteric Pathogen Testing Importance for Children with Acute Gastroenteritis: a Modified Delphi Study
title_short Enteric Pathogen Testing Importance for Children with Acute Gastroenteritis: a Modified Delphi Study
title_sort enteric pathogen testing importance for children with acute gastroenteritis: a modified delphi study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9602993/
https://www.ncbi.nlm.nih.gov/pubmed/36125298
http://dx.doi.org/10.1128/spectrum.01864-22
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