Diagnostic Accuracy of a Pneumonia Panel Multiplex RT-PCR Assay for Detection of Respiratory Bacterial Pathogens Among Pediatric Patients Admitted for Pneumonia at a Tertiary Hospital in Manila, Philippines

Background: Pneumonia in children causes significant morbidity and mortality especially in those less than 5 years of age. Accuracy of multiplex diagnostic tests for rapid identification of microbial etiology is not well-established. This study was undertaken to determine the diagnostic accuracy of a pneumonia panel multiplex RT-PCR assay in the detection of respiratory pathogens among pediatric patients with pneumonia. Methodology: This retrospective analytic cross-sectional study included children less than 19 years old diagnosed with pneumonia between June 2022 to June 2023 with respiratory samples for bacterial culture and pneumonia panel multiplex RT PCR assay. Results: A total of 211 pediatric patients were included in the study. Of these, 72% were diagnosed with community acquired pneumonia, 95% of them had endotracheal aspirate specimens. Bacterial pathogens were detected in 131 patients (61%). Of the 172 patients who had positive detections, 51 (30%) had at least one antibiotic-resistant gene identified. There was moderate agreement between the two methods (72.51%, kappa = 0.4632). Pneumonia panel multiplex RT-PCR assay showed acceptable discriminative ability (0.74) with accuracy at 72.51% and high sensitivity (88.42%), but specificity was only 59.48%. Its use resulted to the escalation of antimicrobial therapy in 15% of patients. Conclusion: The pneumonia panel multiplex RT PCR assay is a valid diagnostic aid in the detection of respiratory pathogens for children with pneumonia given its good discriminative ability, high accuracy, and sensitivity.