Publication:

Rapid multiplex polymerase chain reaction for the detection of respiratory pathogens in pediatric patients under 5 years of age: a single center study

Background Acute respiratory tract infections (ARTIs) are leading causes of morbidity and mortality in children under 5 years, with similar clinical presentations making pathogen identification challenging. The objective of this study is to rapidly detect the causative organism of acute upper respiratory tract infection using the FilmArray respiratory panel 2.1 plus (FARP).

Methods A cross-sectional prospective study was conducted at the Bangladesh Institute of Tropical and Infectious Diseases from September 2024 to February 2025. Nasopharyngeal swab specimens were collected from 60 pediatric patients (≤5 years) presenting with ARTI symptoms within 7 days of onset. Samples were analyzed using FARP 2.1 plus, capable of detecting 19 viruses and 4 atypical bacteria within 45 minutes.

Results The cohort comprised 35 males (58.33%) and 25 females (41.67%) with a mean age of 20±17 months. The diagnostic yield was 95% (57/60). Human rhinovirus/enterovirus was most prevalent (53.3%), followed by respiratory syncytial virus (43.3%) and adenovirus (33.3%). mixed infections predominated, occurring in 55% of cases, with rhinovirus/enterovirus and RSV being the most common combination (21.2%). Age-stratified analysis revealed higher rhinovirus/enterovirus prevalence in infants <1 year (68.1%) compared to children 1-5 years (44.7%).

Conclusions FilmArray demonstrated excellent diagnostic performance with high pathogen detection rates and revealed complex coinfection patterns in pediatric ARTI. The predominance of mixed infections and age-specific pathogen distributions emphasizes the importance of comprehensive molecular diagnostics for optimal clinical management and infection control strategies in pediatric respiratory medicine.