Systematic Review on the Correlation of Quantitative PCR Cycle Threshold Values of Gastrointestinal Pathogens With Patient Clinical Presentation and Outcomes
Background: Quantitative (q) polymerase chain reaction (PCR) cycle threshold (Ct) values represent the number of amplification cycles required for a positive PCR result and are a proxy of pathogen quantity in the tested sample. The clinical utility of Ct values remains unclear for gastrointestinal i...
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doaj-fcb19d5694454e30bdf23217f66a80cf2021-09-23T05:38:59ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-09-01810.3389/fmed.2021.711809711809Systematic Review on the Correlation of Quantitative PCR Cycle Threshold Values of Gastrointestinal Pathogens With Patient Clinical Presentation and OutcomesStéphane Bonacorsi0Benoit Visseaux1Benoit Visseaux2Donia Bouzid3Donia Bouzid4Josep Pareja5Sonia N. Rao6Davide Manissero7Glen Hansen8Glen Hansen9Jordi Vila10Department of Microbiology, Robert Debré University Hospital, AP-HP, Paris, FranceUniversité de Paris, IAME, INSERM, Paris, FranceUniversité de Paris, Laboratoire de Virologie, Hôpital Bichat Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, FranceUniversité de Paris, IAME, INSERM, Paris, FranceUniversité de Paris, Service d'Accueil des Urgences, Hôpital Bichat Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, FranceSTAT-Dx Life, S.L. (a QIAGEN Company), Medical Affairs, Barcelona, SpainQIAGEN Inc., Medical Affairs, Germantown, MD, United StatesQIAGEN Manchester Ltd, Medical Affairs, Manchester, United KingdomMicrobiology and Molecular Diagnostics, Hennepin County Medical Center, Department of Infectious Diseases, School of Medicine, University of Minnesota, Minneapolis, MN, United StatesDepartment of Pathology and Laboratory Medicine, School of Medicine, University of Minnesota, Minneapolis, MN, United States0Biomedical Diagnostic Centre, Department of Clinical Microbiology, Institute of Global Health, School of Medicine, Hospital Clinic, University of Barcelona, Barcelona, SpainBackground: Quantitative (q) polymerase chain reaction (PCR) cycle threshold (Ct) values represent the number of amplification cycles required for a positive PCR result and are a proxy of pathogen quantity in the tested sample. The clinical utility of Ct values remains unclear for gastrointestinal infections.Objectives: This systematic review assesses the global medical literature for associations between Ct values of gastrointestinal pathogens and patient presentation and clinical outcomes.Data Sources: MEDLINE, EMBASE, Cochrane library databases: searched January 14–17, 2020.Study Eligibility Criteria: Studies reporting on the presence or absence of an association between Ct values and clinical outcomes in adult and pediatric populations were included. Animal studies, reviews, meta-analyses, and non-English language studies were excluded.Participants: Humans infected with gastrointestinal pathogens, detected with qPCR.Interventions: Diagnostics assessing Ct values. Extracted data were reported narratively.Results: Thirty-three eligible studies were identified; the most commonly studied pathogens were Clostridioides difficile (n = 15), norovirus (n = 10), and rotavirus (n = 9). Statistically significant associations between low C. difficile Ct values and increased symptom severity or poor outcome were reported in 4/8 (50%) studies, and increased risk of death in 1/2 (50%) studies; no significant associations were found between Ct value and duration of symptoms or length of hospital stay. Among studies of norovirus, 5/7 (71%), mainly genogroup II, reported symptomatic cases with significantly lower median Ct values than controls. Significantly lower rotavirus Ct values were also observed in symptomatic cases vs. controls in 3/7 (43%) studies, and associated with more severe symptoms in 2/2 studies. Contradictory associations were identified for non-C. difficile bacterial and parasitic pathogens.Conclusions: In conclusion, some studies reported clinically useful associations between Ct values and patient or healthcare outcomes; additional, well-designed, large-scale trials are warranted based on these findings.Systematic Review Registration: [PROSPERO], identifier [CRD42020167239].https://www.frontiersin.org/articles/10.3389/fmed.2021.711809/fullcycle thresholdpathogen loadgastrointestinal pathogenssystematic reviewqPCRclinical outcomes |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Stéphane Bonacorsi Benoit Visseaux Benoit Visseaux Donia Bouzid Donia Bouzid Josep Pareja Sonia N. Rao Davide Manissero Glen Hansen Glen Hansen Jordi Vila |
spellingShingle |
Stéphane Bonacorsi Benoit Visseaux Benoit Visseaux Donia Bouzid Donia Bouzid Josep Pareja Sonia N. Rao Davide Manissero Glen Hansen Glen Hansen Jordi Vila Systematic Review on the Correlation of Quantitative PCR Cycle Threshold Values of Gastrointestinal Pathogens With Patient Clinical Presentation and Outcomes Frontiers in Medicine cycle threshold pathogen load gastrointestinal pathogens systematic review qPCR clinical outcomes |
author_facet |
Stéphane Bonacorsi Benoit Visseaux Benoit Visseaux Donia Bouzid Donia Bouzid Josep Pareja Sonia N. Rao Davide Manissero Glen Hansen Glen Hansen Jordi Vila |
author_sort |
Stéphane Bonacorsi |
title |
Systematic Review on the Correlation of Quantitative PCR Cycle Threshold Values of Gastrointestinal Pathogens With Patient Clinical Presentation and Outcomes |
title_short |
Systematic Review on the Correlation of Quantitative PCR Cycle Threshold Values of Gastrointestinal Pathogens With Patient Clinical Presentation and Outcomes |
title_full |
Systematic Review on the Correlation of Quantitative PCR Cycle Threshold Values of Gastrointestinal Pathogens With Patient Clinical Presentation and Outcomes |
title_fullStr |
Systematic Review on the Correlation of Quantitative PCR Cycle Threshold Values of Gastrointestinal Pathogens With Patient Clinical Presentation and Outcomes |
title_full_unstemmed |
Systematic Review on the Correlation of Quantitative PCR Cycle Threshold Values of Gastrointestinal Pathogens With Patient Clinical Presentation and Outcomes |
title_sort |
systematic review on the correlation of quantitative pcr cycle threshold values of gastrointestinal pathogens with patient clinical presentation and outcomes |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Medicine |
issn |
2296-858X |
publishDate |
2021-09-01 |
description |
Background: Quantitative (q) polymerase chain reaction (PCR) cycle threshold (Ct) values represent the number of amplification cycles required for a positive PCR result and are a proxy of pathogen quantity in the tested sample. The clinical utility of Ct values remains unclear for gastrointestinal infections.Objectives: This systematic review assesses the global medical literature for associations between Ct values of gastrointestinal pathogens and patient presentation and clinical outcomes.Data Sources: MEDLINE, EMBASE, Cochrane library databases: searched January 14–17, 2020.Study Eligibility Criteria: Studies reporting on the presence or absence of an association between Ct values and clinical outcomes in adult and pediatric populations were included. Animal studies, reviews, meta-analyses, and non-English language studies were excluded.Participants: Humans infected with gastrointestinal pathogens, detected with qPCR.Interventions: Diagnostics assessing Ct values. Extracted data were reported narratively.Results: Thirty-three eligible studies were identified; the most commonly studied pathogens were Clostridioides difficile (n = 15), norovirus (n = 10), and rotavirus (n = 9). Statistically significant associations between low C. difficile Ct values and increased symptom severity or poor outcome were reported in 4/8 (50%) studies, and increased risk of death in 1/2 (50%) studies; no significant associations were found between Ct value and duration of symptoms or length of hospital stay. Among studies of norovirus, 5/7 (71%), mainly genogroup II, reported symptomatic cases with significantly lower median Ct values than controls. Significantly lower rotavirus Ct values were also observed in symptomatic cases vs. controls in 3/7 (43%) studies, and associated with more severe symptoms in 2/2 studies. Contradictory associations were identified for non-C. difficile bacterial and parasitic pathogens.Conclusions: In conclusion, some studies reported clinically useful associations between Ct values and patient or healthcare outcomes; additional, well-designed, large-scale trials are warranted based on these findings.Systematic Review Registration: [PROSPERO], identifier [CRD42020167239]. |
topic |
cycle threshold pathogen load gastrointestinal pathogens systematic review qPCR clinical outcomes |
url |
https://www.frontiersin.org/articles/10.3389/fmed.2021.711809/full |
work_keys_str_mv |
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