Panels and syndromic testing in clinical microbiology
Open accessAbstract
Syndromic panels have allowed clinical microbiology laboratories to rapidly identify bacteria, viruses, fungi, and parasites and are now fully integrated into the standard testing practices of many clinical laboratories. To maximize the benefit of syndromic testing, laboratories must implement strict measures to ensure that syndromic panels are being used responsibly. This article discusses commercially available syndromic panels, the benefits and limitations of testing, and how diagnostic and laboratory stewardship can be used to optimize testing and improve patient care while keeping costs at a minimum.
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Detection of human herpesvirus-6 may reflect chromosomally integrated viral DNA rather than active infection, particularly in immunocompetent individuals.
“For example, the detection of human herpesvirus-6 (HHV-6) may reflect chromosomally integrated viral DNA rather than active infection, particularly in immunocompetent individuals.”
From Utility and clinical relevance of multiplex PCR panels for diagnosis of central nervous system infections (2026) · cites this paper as [1]
The Meningitis/encephalitis syndromic panel section (page not provided) says HHV-6 detection may represent chromosomally integrated virus rather than true infection. It does not say this explanation is particularly likely in immunocompetent individuals; it notes that most patients with reported HHV-6 central nervous system infections in one pediatric study were immunocompetent. (LLM, conf=0.85)
Experimental — accuracy not yet measuredCentral nervous system infections such as meningitis and encephalitis pose significant diagnostic challenges because of overlap in their clinical presentations.
“Central nervous system (CNS) infections such as meningitis and encephalitis pose significant diagnostic challenges because of overlap in their clinical presentations.1”
From Utility and clinical relevance of multiplex PCR panels for diagnosis of central nervous system infections (2026) · cites this paper as [1]
The Meningitis/encephalitis syndromic panel section describes CNS infections as having many infectious causes and says improved diagnostics are needed because conventional methods have shortcomings. It does not attribute the diagnostic challenge to overlapping clinical presentations of meningitis and encephalitis. No page number is available in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredEpstein-Barr virus positivity in cerebrospinal fluid may indicate latent infection without central nervous system involvement.
“Similarly, Epstein-Barr virus (EBV) positivity in CSF may indicate latent infection without CNS involvement.1,5,6”
From Utility and clinical relevance of multiplex PCR panels for diagnosis of central nervous system infections (2026) · cites this paper as [1]
The Meningitis/encephalitis syndromic panel section discusses whether a positive HHV-6 result reflects a true CNS infection, but it does not make this point about Epstein–Barr virus. Searches for EBV positivity, latency, and CSF returned no passage addressing the claim; page numbers were unavailable in our copy. (LLM, conf=0.76)
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Effective approaches to diagnostic stewardship of syndromic molecular panels
Hitchcock, M. M., Gomez, C. A., Pozdol, J., & Banaei, N. (2024) · The Journal of Applied Laboratory Medicine · doi:10.1093/jalm/jfad063 · Cited by 20 · see citing works
Gürler, M., Karaoğlu, Ç., Yurtcu, E. E., Us, E., & Karahan, Z. C. (2026) · The Indian Journal of Medical Research · doi:10.25259/ijmr_2107_2025
“1,5,6 Currently, two FDA-approved multiplex panels are widely used for the diagnosis of meningitis and encephalitis: the FilmArray Meningitis/Encephalitis (M&E) Panel (BioMérieux, France) and the QIAstat-Dx Meningitis/Encephalitis Panel (Qiagen, USA).”
- Authors
- Dien Bard, J., & McElvania, E.
- Affiliations
- Endeavor Health (US)
- ORCID
- McElvania, Erin
- Venue
- Clinics in Laboratory Medicine
- Publisher
- Elsevier BV
- Published
- 2020-12
- Volume
- 40
- Issue
- 4
- Pages
- 393-420
- ISSN
- 0272-2712 (ISSN-L)
- PMC
- PMC7528880
- OpenAlex
- W3089712858
- Cited by
- 92
- References
- 53
- Citations by year
- 2026: 16 · 2025: 13 · 2024: 22 · 2023: 24 · 2022: 10 · 2021: 7
- FWCI
- 1.29
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Clinics in Laboratory Medicine (acceptedVersion)
- PubMed (publishedVersion)
- Funders
- BD
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
- Keywords
- multiplex PCR, clinical microbiology testing, laboratory stewardship, antimicrobial stewardship, diagnostic stewardship, pathogen identification, cost reduction
- MeSH terms
- Humans, Infections, Microbiological Techniques, Molecular Diagnostic Techniques
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